NP Core Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Introduction
Official URL: http://fhir.digitalhealth.gov.np/core/ImplementationGuide/np.core
The Nepal Core FHIR Implementation Guide (NP Core IG) establishes a national baseline for health data interoperability in Nepal, built on the HL7 FHIR R4 standard. It is published by the Ministry of Health and Food Safety (MoHFS) and is intended to be eventually adopted by digital health systems operating within the country.
NP Core provides a curated set of FHIR profiles, extensions, terminology, and identifier systems that encode Nepal-specific requirements (such as the country's federal administrative geography, national identification schemes, professional registration councils, and health facility registry) into a structured, machine-readable format that any FHIR-capable system can consume.
Background
Nepal adopted a federal structure in 2015 and has since reorganised its public administration into 7 Provinces, 77 Districts, and 753 Local Levels (municipalities and rural municipalities). Health service delivery is likewise structured across these three tiers, from federal hospitals to health posts and community health units at the local level.
This Implementation Guide identifies several registries and identification systems that are central to health information management:
Registry / System
Authority
Purpose
National ID
DONIDCR
Citizen identity
Health ID
MoHFS
Longitudinal patient identity
National Health Facility Registry (NHFR)
MoHFS
Unique identification of health facilities
Nepal Medical Council (NMC)
NMC
Registration of medical doctors
Nepal Nursing Council (NNC)
NNC
Registration of nurses and midwives
Nepal Ayurveda Medical Council (NAMC)
NAMC
Registration of Ayurvedic practitioners
Nepal Health Professional Council (NHPC)
NHPC
Registration of allied health professionals
Nepal Pharmacy Council (NPC)
NPC
Registration of pharmacists
NP Core translates each of these registries into formal FHIR NamingSystem resources and associated Identifier profiles, enabling reliable cross-system referencing of patients, practitioners, and facilities.
Extensions — Nepal address coded geography, caste/ethnicity, and preservation of the original Bikram Sambat date behind a Gregorian value (see Calendar and Dates).
Terminology — CodeSystems and ValueSets for facility type, ownership, level, administrative geography, caste and ethnicity, and clinical document types.
Identifier Systems — NamingSystems and Identifier profiles for national IDs, Health IDs, practitioner council registrations, and the National Health Facility Registry.
Out of scope for the current version (v1.0.0):
Full national drug coding. An interim placeholder drug code system with a small seed of generic medicines is included (see Terminology); the authoritative code system will be developed by the Department of Drug Administration (DDA).
Elements marked Must Support (MS) in NP Core profiles are elements that conformant systems must be capable of handling. The meaning of "handling" differs by actor, which is expressed through obligations.
NP Core defines three actors:
Actor
Role
NP Core Creator
A system that produces NP Core resources (e.g. HIS, EMR)
NP Core Consumer
A system that receives and uses NP Core resources (e.g. analytics, Patient Portal)
NP Core Server
A FHIR server that stores and serves NP Core resources
Each Must Support element carries one of four obligation tiers:
Tier
Creator
Consumer & Server
Required
SHALL be able to populate
SHALL handle
Recommended
SHOULD be able to populate
SHALL handle
Populate-if-known
SHALL populate when data is known
SHALL handle
Optional
MAY populate
SHALL handle
See the Actors & Obligations page for more details on the obligation tiers and actors.
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 (np.core.r4) and R4B (np.core.r4b) are available.
Intellectual Property and Usage Statements
This publication includes IP covered under the following statements.
This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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.extensions.r4#5.3.0
This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, May 16, 2026 18:32+1000+10:00)
Package hl7.fhir.uv.tools.r4#1.3.0
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, Oct 6, 2026 15:55+1100+11:00)
