PH eReferral Implementation Guide, published by UP Manila SILab. This guide is not an authorized publication; it is the continuous build for version 0.3.0-draft built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/jgsuess/ph-ereferral/ and changes regularly. See the Directory of published versions
Resource Architecture
Resource Architecture
This page documents the FHIR resource types used in the eReferral scenario, how they are grouped into transaction bundles, which FHIR design patterns they follow, and how the clinical workflow and data-dictionary mapping are visualised. For the source artefact descriptions and the agile methodology, see the Approach page.
Resource Diagram
The diagram below shows the FHIR resource types used and their relationships.
The 22 example resources are split across two transaction bundles that mirror the two business processes in the ANC scenario.
Bundle A — Registration (Process A)
Clerk Abraham registers patient Charity during her first visit. This bundle collects the demographic and administrative resources created at the front desk.
Resource
Instance ID
Key DD Elements
Patient
patient-charity-ex
REF-20 … REF-27
RelatedPerson
relatedperson-companion-ex
REF-28
Organization
organization-sending-facility-ex
REF-4 … REF-7
Practitioner
practitioner-abraham-ex
REF-1
PractitionerRole
practitionerrole-abraham-ex
REF-1
Encounter
encounter-registration-ex
REF-43
Bundle B — ANC Contact (Process B)
Nurse Jane conducts the antenatal care contact — recording clinical observations, dispensing medication, ordering lab tests, and creating the ultrasound referral.
Resource
Instance ID
Key DD Elements
Practitioner
practitioner-jane-ex
REF-1
PractitionerRole
practitionerrole-jane-ex
REF-1
Organization
organization-receiving-facility-ex
REF-9, REF-10
Encounter
encounter-anc-ex
REF-43
Condition
condition-pregnancy-ex
REF-40
Observation ×7
chief complaint, BP, HR, RR, SpO₂, temp, weight
REF-30, REF-32 … REF-37
MedicationAdministration
medicationadministration-ifa-ex
REF-38
ServiceRequest ×2
ultrasound referral, lab orders
REF-12, REF-13, REF-15, REF-31, REF-39
Task
task-referral-ex
REF-16, REF-42
FHIR Design Patterns
The FHIR specification defines a set of reusable Design Patterns that standardise how resources behave across clinical, administrative, and workflow domains. The table below shows which patterns this IG relies on and how they map to the eReferral resources.
The ultrasound referral and laboratory orders follow the Request pattern — they capture the intent, priority, and coded reason for a service to be performed.
Clinical acts that have already occurred use the Event pattern — vital-sign observations, medication dispensing, encounter records, and the pregnancy condition all carry status, timing, and performer.
People and organisations are modelled with the Participant pattern. PractitionerRole links a Practitioner to an Organization and role code, following the Participant and RoleEntity pattern.
The referral lifecycle uses the Workflow pattern: a ServiceRequest expresses the clinical intent, while a Task tracks fulfilment state (requested → received → accepted). This follows the ServiceRequest + Task coordination approach.
Vital signs and the chief complaint follow the Observation pattern with LOINC-coded types and quantity values. Blood pressure uses the component pattern for systolic/diastolic.
Registration and ANC-contact resources are grouped into transaction Bundles, ensuring atomic submission of related resources.
Further reading: The FHIR Design Patterns overview explains the rationale behind these abstractions and how they promote consistency across implementation guides.
Scenario Activity Flow
The following activity diagram traces the clinical workflow through the two business processes, showing how Charity moves from registration with Abraham through to the ANC contact with Jane.
Data Dictionary to FHIR Mapping Diagram
The mapping diagram below provides a high-level view of how the seven clinical information groups in the data dictionary map to FHIR resource types. For the detailed element-by-element mapping, see the DD Mapping page.