Bangladesh Core FHIR Implementation Guide
0.5.0 - Published by DGHS, MoHFW
Bangladesh Core FHIR Implementation Guide
0.5.0 - Published by DGHS, MoHFW
Bangladesh Core FHIR Implementation Guide - Published by Ministry of Health and Family Welfare. See the Directory of published versions
| Page standards status: Trial-use |
This Implementation Guide (IG) defines the national FHIR R4 core profiles, value sets, code systems, extensions, and implementation rules for digital health systems in Bangladesh. It is published by the Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MoHFW).
This IG is a foundational component of the Shareable Health Record (SHR) system — the national Health Information Exchange (HIE) and gateway for producing a Personal Health Profile for every citizen of Bangladesh.
This IG is aligned with and gives technical expression to:
The Patient profile strictly conforms to the Citizen Core Data Structure (CCDS) defined by the Cabinet Division of the Government of Bangladesh.
This IG is addressed to all software systems exchanging health data with the national SHR, including but not limited to:
This includes systems operated by public sector facilities, private hospitals and clinics, autonomous bodies, and non-governmental organisations (NGOs) operating within Bangladesh.
This IG is built on FHIR R4 (4.0.1). All profiles, extensions, value sets, and code systems defined here conform to the FHIR R4 specification.
Conformance language in this IG follows RFC 2119: SHALL, SHALL NOT, SHOULD, SHOULD NOT, and MAY carry their standard normative meanings.
1. National terminology over international defaults
Where international code systems are used (ICD-11, LOINC),
they are bound through national infrastructure. The national OpenConceptLab
(OCL) terminology server at https://tr.ocl.dghs.gov.bd is the single
public-facing terminology resolution point. Vendors never interact with
upstream terminology sources directly.
2. HIE boundary enforcement All vendor submissions pass through the national SHR HIE boundary. Mandatory validation gates — including the Bangladesh ICD-11 Cluster Validator — are applied at the HIE layer. Profile conformance is a necessary but not sufficient condition for acceptance; HIE boundary rules apply additionally.
3. Open slicing for extensibility
Where slices are defined on coding elements, slicing is open (#open).
Mandatory slices enforce the presence of nationally required codes;
additional local or proprietary codings are permitted alongside them.
This ensures national interoperability without preventing systems from
carrying additional coded data.
4. Citizen-centred identity The Patient profile conforms to the Citizen Core Data Structure (CCDS), ensuring that patient identity in the SHR is anchored to the national citizen identity infrastructure.
5. Must Support obligations Must Support (MS) in this IG means that conformant systems SHALL be capable of populating the element if the data is held by the system, and SHALL be capable of processing it when received. Specific sender and receiver obligations will be refined as vendors are onboarded.
The following national core profiles are defined in this IG:
| Profile | Base Resource | Purpose |
|---|---|---|
| BD Patient | Patient | Citizen identity conforming to CCDS |
| BD Condition | Condition | Clinical conditions coded with ICD-11 MMS |
| BD Observation | Observation | Base profile for observations; not used directly. Derived profiles cover laboratory panels and results (vital signs and examination profiles are planned) |
| BD Encounter | Encounter | Clinical visits and episodes of care |
| BD Medication | Medication | Medication definitions |
| BD MedicationRequest | MedicationRequest | Prescriptions and medication orders |
| BD Immunization | Immunization | Vaccination records |
| BD Organization | Organization | Health facilities and organisations |
| BD Practitioner | Practitioner | Healthcare providers |
| BD Location | Location | Locations, such as the place of immunization |
| BD Address | Address | Bangladesh address structure (division, district, upazila) |
| BD RelatedPerson | RelatedPerson | Relatives and other persons related to a patient |
| BD Laboratory Panel Observation | Observation | Laboratory panel (order level) grouping its results through hasMember |
| BD Laboratory Result Observation | Observation | Individual laboratory result, numeric or coded |
| BD Laboratory Report | DiagnosticReport | Laboratory report referencing panels and results |
The following external code systems are used in this IG:
| System | URI | Purpose |
|---|---|---|
| ICD-11 MMS | http://id.who.int/icd/release/11/mms |
Condition coding |
| LOINC | http://loinc.org |
Laboratory test, panel and answer coding |
| UCUM | http://unitsofmeasure.org |
Observation units |
| EDQM Standard Terms | http://standardterms.edqm.eu |
Pharmaceutical dose forms |
National code systems and value sets (for example the geographic codes and the DGDA drug registry) are listed in the Artifact Index.
Runtime terminology resolution is provided by the national OCL terminology server. See the ICD-11 Implementation page for full details of ICD-11 integration, postcoordination conventions, and conformance requirements.
This IG is under active development; released versions are listed in the version history. The following are known gaps to be addressed in future revisions: