PH eReferral Implementation Guide, published by UP Manila SILab. 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/ph-ereferral-organization/ph-ereferral/ and changes regularly. See the Directory of published versions

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Official URL: urn://example.com/ph-ereferral/fhir/ImplementationGuide/example.fhir.ph.ereferral				Version: 0.1.0
Draft as of 2026-04-01				Computable Name: PHeReferralImplementationGuide

Philippine eReferral Implementation Guide (PH eReferral IG)

Project Status: In Development This Implementation Guide is under active development and is not yet available for public or production use. Content, data models, and implementation details are subject to change.

Introduction

The Philippine eReferral Implementation Guide (PH eReferral IG) is a use case Implementation Guide that provides a standardized approach for electronic referral workflows within Health Care Provider Networks (HCPNs) in the Philippines. It defines the minimum FHIR-based requirements to support seamless referral of patients between healthcare providers using HL7^® FHIR^®© standards.

This IG aligns with the Universal Health Care Act (Republic Act 11223) and DOH Administrative Order 2020-0019, which mandates interoperable health information systems for integrated care across HCPNs. It enables FHIR-based referral messaging, patient navigation, and back-referral workflows consistent with the AO's Annex D requirements.

This FHIR IG is provided for testing purposes and is not yet suitable for production systems.

What is a Use Case IG?

A use case Implementation Guide builds upon foundational and core standards to address a specific clinical or administrative workflow. Unlike base or core IGs that establish broad interoperability foundations, a use case IG:

• Targets a specific workflow — in this case, the patient referral process between healthcare facilities
• Profiles core resources for the use case — constrains and extends PH Core profiles to meet referral-specific requirements
• Defines actors and interactions — identifies systems, users, and the exchanges between them
• Specifies business rules — documents the rules governing referral lifecycle, status transitions, and required data elements

PH eReferral demonstrates how FHIR resources can be applied to solve a real-world interoperability challenge in the Philippine healthcare system.

Purpose and Scope

The PH eReferral IG aims to:

1. Enable standardized electronic referral workflows between healthcare facilities within HCPNs
2. Support patient care continuity through interoperable FHIR-based data exchange
3. Implement UHC Act (RA 11223) and DOH AO 2020-0019 requirements for referral systems
4. Provide clear, testable specifications for HCPN referral system implementers

This guide focuses on referral-specific FHIR resources (e.g., ServiceRequest, Task, Communication) and their relationships with core clinical and administrative resources (Patient, Practitioner, Organization, Encounter).

It does not define general clinical workflows outside the referral context.

Usage of this Guide

• Healthcare Facilities: Implement eReferral profiles to enable standardized patient referrals
• Health Information Systems: Use as a baseline for developing interoperable referral capabilities
• Developers and Vendors: Build and validate FHIR-conformant referral systems

Relationship with Other IGs

PH eReferral fits into the Philippine FHIR IG architecture as a use case layer implementation guide that builds upon foundational profiles:

Layer	IG	Purpose
Core	PH Core IG	Base profiles – Foundational rules, common extensions, and national identifiers (Patient, Practitioner, Organization, Encounter, etc.)
Use Case	PH eReferral IG	Referral-specific workflows and interactions – HCPN referral messaging built on PH Core
Program	Program-specific IGs	Tailored implementations for specific health programs or facilities

PH Core provides the parent/base profiles used by this IG. PH eReferral:

• Uses PH Core as its foundation – inheriting constraints from PH Core profiles (Patient, Practitioner, Organization, Encounter, etc.)
• Defines referral-specific profiles (ServiceRequest, Task, etc.) for interoperability
• Specifies the referral workflow actors and their interactions
• Documents the complete referral lifecycle from creation to fulfillment
• Provides RESTful API guidance for referral operations

This layered approach enables reuse of common PH Core definitions while addressing the specific needs of HCPN referral workflows mandated by the UHC Act.

Dependencies

No use of external IP (other than from the FHIR specification)

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (example.fhir.ph.ereferral.r4) and R4B (example.fhir.ph.ereferral.r4b) are available.

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package hl7.fhir.uv.tools.r4#1.1.2 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Mar 24, 2026 11:13+1100+11:00)

Implementation Guide	Version(s)	Reason
FHIR Extensions Pack	5.2.0	Automatically added as a dependency - all IGs depend on the HL7 Extension Pack
FHIR R4 package : Core	4.0.1	Imported by HL7 Terminology (THO) (and potentially others)
HL7 Terminology (THO)	7.1.0	Automatically added as a dependency - all IGs depend on HL7 Terminology

There are no Global profiles defined