# Health Journey Opd - Amakomaya Nepal FHIR Implementation Guide v2.0.0

* [**Table of Contents**](toc.md)
* **Health Journey Opd**

## Health Journey Opd

This use case describes the process of capturing and exchanging data related to **Outpatient Department (OPD)** services in health facilities using FHIR.

### Objective

To ensure standardized data capture and reporting for OPD consultations across public health facilities, aligning with EHMIS reporting requirements.

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### Actors

* Patient
* Health Worker (e.g., Medical Officer, Health Assistant, ANM)
* OPD Registration Clerk

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### Workflow Steps

1. **Registration at OPD Desk**
* Capture patient demographic info
* FHIR Resource: `Patient`
* Optional linking to previous visit using `Encounter`

1. **OPD Encounter Starts**
* FHIR Resource: `Encounter`
* Type: OPD Visit
* Status: in-progress → finished

1. **Chief Complaints and History Taking**
* FHIR Resource: `Observation` (e.g., symptoms, duration)
* May also use `Condition` for known diseases

1. **Physical Examination**
* Vitals: BP, temperature, pulse, weight
* FHIR Resource: `Observation`

1. **Diagnosis**
* Primary and secondary diagnosis
* ICD-10/ICPC coding recommended
* FHIR Resource: `Condition`

1. **Treatment/Prescription**
* Medications prescribed (with dosage, frequency, duration)
* FHIR Resource: `MedicationRequest`

1. **Referral or Advice**
* If referred to specialist or hospital
* FHIR Resource: `ReferralRequest` or `ServiceRequest`

1. **OPD Visit Completion**
* `Encounter.status = finished`

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### FHIR Resources Used

| | |
| :--- | :--- |
| `Patient` | To capture demographic info |
| `Encounter` | To record the OPD consultation |
| `Observation` | Vitals, symptoms, lab values |
| `Condition` | Diagnoses |
| `MedicationRequest` | Prescriptions |
| `ServiceRequest` | Diagnostic or specialist referral |

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### Example: OPD for a 45-Year-Old Male with Fever

* **Patient**: Registered with demographics
* **Encounter**: OPD visit on 2025-08-08
* **Observation**: 
* Temperature: 101°F
* Blood pressure: 130/85
 
* **Condition**: Acute febrile illness
* **MedicationRequest**: Paracetamol 500mg TID × 3 days

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### Reporting Considerations

* Monthly OPD data can be aggregated using: 
* Condition types
* Age/sex disaggregation
* Visit counts
 
* Can be linked to DHIS2 datasets through mapping

