Philippine Core Data for Interoperability (PHCDI) — FHIR Implementation Guide

Source: https://build.fhir.org/ig/UP-Manila-SILab/PhilHealth-NHDR-IG-Review/ Version: Release 1.0 v0.1.0 Base: FHIR R4 (4.0.1) Developed by: UP Manila National TeleHealth Center / SILab, with CSIRO Australia technical assistance

Overview

PHCDI sets the minimum requirements for FHIR resource use in Philippine health systems. It defines PH-specific profiles, extensions, value sets, and code systems that enable interoperability between hospitals, primary care facilities, PhilHealth, and DOH systems via the National Health Data Repository (NHDR).

Modeled after global initiatives (US Core Data for Interoperability, Argonaut Project) but tailored to Philippine healthcare needs.

Architecture Layers

PH Base IG (foundational national rules)
  └→ PH Core IG (common profiles, terminology)
       └→ NHDR IG / PHCDI (NHDR-specific use cases)
            └→ Program-specific IGs (future)

Actors

• Philippine Core Requestor: Client applications that initiate data access requests
• Philippine Core Responder: Server systems providing patient data in response

FHIR Profiles Defined

Foundation

Profile	FHIR Resource	Purpose
PH Provenance	Provenance	Records entities and processes involved in producing resources

Base (Administrative)

Profile	FHIR Resource	Purpose
PH Appointment	Appointment	Healthcare event bookings
PH Encounter	Encounter	Patient-provider interactions
PH Organization	Organization	Healthcare facility/org records
PH Patient	Patient	Demographics and admin info
PH Person	Person	Demographics independent of health context
PH Practitioner	Practitioner	Healthcare providers
PH PractitionerRole	PractitionerRole	Practitioner roles at organizations
PH RelatedPerson	RelatedPerson	Non-primary care participants (family, guardians)

Clinical

Profile	FHIR Resource	Purpose
PH AllergyIntolerance	AllergyIntolerance	Adverse substance reactions
PH CarePlan	CarePlan	Care delivery intentions
PH ClinicalImpression	ClinicalImpression	Clinical assessments
PH Condition	Condition	Diagnoses and clinical problems
PH DiagnosticReport	DiagnosticReport	Test findings and interpretations
PH FamilyMemberHistory	FamilyMemberHistory	Related health conditions
PH Goal	Goal	Intended care objectives
PH Immunization	Immunization	Vaccine administration events
PH Medication	Medication	Medication identification
PH MedicationAdministration	MedicationAdministration	Medication consumption events
PH MedicationDispense	MedicationDispense	Medication dispensing records
PH MedicationRequest	MedicationRequest	Medication orders (prescriptions)
PH MedicationStatement	MedicationStatement	Active medication records
PH Observation	Observation	Measurements, vitals, lab results
PH Procedure	Procedure	Performed healthcare actions
PH QuestionnaireResponse	QuestionnaireResponse	Structured form responses
PH ServiceRequest	ServiceRequest	Diagnostic/treatment requests
PH Specimen	Specimen	Analysis samples

Financial

Profile	FHIR Resource	Purpose
PH Claim	Claim	Professional services reimbursement (maps to CF1-CF4)
PH Coverage	Coverage	Insurance and payment instruments (PhilHealth membership)
PH EnrollmentRequest	EnrollmentRequest	Insurance enrollment

Specialized

Profile	FHIR Resource	Purpose
PH Questionnaire	Questionnaire	Structured data collection forms

PH-Specific Extensions (30)

Geographic (Philippine addressing)

• Barangay Code, City Code, Province, Region Code — mapped to PSGC (Philippine Standard Geographic Code)

Patient Demographics

• Age in Days/Months/Years
• Educational Attainment (PSCED codes)
• Indigenous Group, Indigenous Status
• Marital Status, Occupation, Race, Sex at Birth

Clinical/Administrative

• Date of Interview, Investigation, Result
• Encounter (extension), Address (extension)
• Interviewer, Investigator, Reporter names
• Medication Type, Package Description
• Member Type, Patient Classification, Patient Type
• Position of Signatory, Reason for Signature
• Specimen Release Date
• HFLastUpdated, HFRecordedDate (facility timestamps)

Value Sets (21)

Geographic (Philippine-specific)

• Barangay Codes (PSGC), City Codes, Province Codes, Region Codes

Clinical

• Drug Codes (FDA pharmaceutical products)
• ICD-10 Codes (disease classification)
• Procedure Codes (RVS — Relative Value Scale)
• Observation Values

Administrative

• Educational Attainment (PSCED)
• Facility Major Type
• Health Facility Codes (DOH NHFR)
• Indigenous Groups
• Member Type (PhilHealth)
• Occupation Classification (PSOC)
• Patient Type
• Practitioner Role
• Service Type
• Sex, Signature Type
• PhilHealth Regional Offices
• Local Health Insurance Offices
• Coverage Copay Type

Code Systems (16)

Philippine Standards

• PSGC (geographic), PSCED (education), PSOC (occupation)

Healthcare

• Drug Codes (FDA), NHFR (facility registry), RVS (procedures)

Local

• Coverage copay types, facility types, indigenous groups, insurance offices, member types, observation values, organization types, ownership classifications, patient types, PhilHealth regional offices, signature types

Claims Form Mapping

The FHIR IG includes example bundles mapping PhilHealth Claims Forms to FHIR:

• CF1 → Bundle with Patient, Coverage, EnrollmentRequest resources
• CF2 → Bundle with Encounter, Condition, Procedure, Claim resources
• CF3 → Practitioner, PractitionerRole, ServiceRequest resources
• CF4 → Medication, MedicationAdministration, MedicationDispense resources

Global Standards Referenced

Standard	Usage in PHCDI
HL7 FHIR R4	Base specification
ICD-10 (WHO)	Diagnosis coding via PH Condition profile
RVS (Relative Value Scale)	Procedure coding
PSGC (PSA)	Geographic coding for addresses
PSCED (PSA)	Educational attainment coding
PSOC (PSA)	Occupation classification
NHFR (DOH)	Health facility identification
FDA Drug Codes	Medication identification

What PHCDI Does NOT Cover (gaps for platform builders)

1. Lab result coding — no LOINC adoption yet. Lab results use free-text observations.
2. Clinical terminology — no SNOMED CT. Diagnoses use ICD-10 only.
3. Imaging — no DICOM integration profile.
4. Referral workflows — no formal referral resource profile.
5. Scheduling — Appointment profile exists but scheduling workflow not defined.
6. Consent management — no Consent resource profile despite Data Privacy Act requirements.
7. Care coordination — CarePlan profile exists but no care team or episode of care profiles.
8. Real-time messaging — no Subscription or messaging framework defined.

For Platform Builders

If building a system that interoperates with NHDR:

1. Implement PH Patient, PH Encounter, PH Condition, PH Claim at minimum
2. Use PSGC for all geographic data (barangay → city → province → region)
3. Map PhilHealth Claims Forms to the FHIR bundle examples
4. Support ICD-10 for diagnoses, RVS for procedures
5. Register with DOH NHFR for facility codes

If building a system that GOES BEYOND NHDR:

1. Add LOINC for lab results (NHDR will eventually adopt this)
2. Add SNOMED CT for clinical terminology (future-proofing)
3. Add DICOM references for imaging
4. Implement Consent resource for Data Privacy Act compliance
5. Add CareTeam, EpisodeOfCare for care coordination
6. Build Subscription-based real-time notifications