#

input/bd.fhir.core.xml

@@ -13,7 +13,7 @@
   </extension>-->
   <url value="https://fhir.dghs.gov.bd/core/ImplementationGuide/bd.fhir.core"/>
   <!-- This version will propagate to all artifacts unless the "propagate-version" extension is overridden -->
-  <version value="0.2.4"/>
+  <version value="0.4.6"/>
   <name value="BangladeshCoreFHIRIG"/>
   <title value="Bangladesh Core FHIR Implementation Guide"/>
   <status value="active"/>
@@ -102,6 +102,11 @@
         <title value="IG Change History"/>
         <generation value="html"/>
       </page>
+      <page>
+        <nameUrl value="history.html"/>
+        <title value="Version History"/>
+        <generation value="html"/>
+      </page>
     </page>
     <!-- copyright year is a mandatory parameter -->
     <parameter>

input/fsh/BDConditionProfile.fsh

@@ -1,8 +0,0 @@
-Profile: BDConditionProfile
-Parent: Condition
-Id: bd-condition
-Title: "ICD 11"
-Description: "Condition coded with ICD-11"
-
-* code 1..1 MS
-* code from BDConditionICD11VS (preferred)

input/fsh/codeSystems/BDDGDADrugCS.fsh

@@ -0,0 +1,33 @@
+CodeSystem: BDDGDADrugCS
+Id: dgda-drug-registry
+Title: "DGDA Drug Registry Code System"
+Description: """
+Code system representing the Drug Registration Authority (DGDA) of Bangladesh's
+official drug registry. Concepts are maintained in the national OCL terminology
+server at https://tr.ocl.dghs.gov.bd and are not enumerated within this
+Implementation Guide.
+
+This code system contains two concept classes:
+- **Drug**: Finished pharmaceutical drug products (identified by DAR number and trade name)
+- **Ingredient**: Raw material / active pharmaceutical ingredients
+
+Concept IDs follow the format: {DAR-number}--{trade-name-slug}
+Example: 353-0026-039--marvelous-fe
+
+**Canonical URL note:** https://dgda.gov.bd/drug-registry is a logical identifier
+only and does not resolve to a web endpoint.
+"""
+
+* ^url = "https://dgda.gov.bd/drug-registry"
+* ^version = "v1.0.0"
+* ^status = #active
+* ^experimental = false
+* ^publisher = "Directorate General of Drug Administration (DGDA), Government of Bangladesh"
+* ^contact.name = "DGHS Health Informatics Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^content = #not-present
+* ^count = 39196
+* ^caseSensitive = true
+* ^valueSet = "https://dgda.gov.bd/fhir/ValueSet/registered-drugs"

input/fsh/codeSystems/BDMaritalStatusCS.fsh

@@ -0,0 +1,18 @@
+//codeSystems/bd-regions.fsh
+CodeSystem: BDMaritalStatusCS
+Id: bd-marital-status
+Title: "Bangladesh Marital Status"
+* ^url =  "https://fhir.dghs.gov.bd/core/CodeSystem/bd-marital-status"
+
+* #1 "Unmarried" "Unmarried"
+* #2 "Married" "Married"
+* #3 "Widowed" "Widowed"
+* #4 "Separated" "Separated"
+* #5 "Divorced" "Divorced"
+
+ValueSet: BDMaritalStatusVS 
+Id: bd-marital-status-valueset
+Title: "Bangladesh Marital Status ValueSet"
+Description: "Marital status value set according to CCDS guideline"
+* ^url =  "https://fhir.dghs.gov.bd/core/ValueSet/bd-marital-status-valueset"
+* include codes from system https://fhir.dghs.gov.bd/core/CodeSystem/bd-marital-status

input/fsh/codeSystems/BDMedicationCS.fsh

@@ -1,4 +1,4 @@
-CodeSystem: BDMedicationCodeSystem
+CodeSystem: BDMedicationCS
 Id: bd-medication-code
 Title: "Bangladesh Medication Codes"
 Description: "Bangladesh Medication Codes"
@@ -21,4 +21,4 @@ ValueSet: BDMedicationVS
 Id: bd-medication-valueset
 Title: "Bangladesh Medication ValueSet"
 Description: "Bangladesh Medication ValueSet"
-* include codes from system BDMedicationCodeSystem
+* include codes from system BDMedicationCS

input/fsh/codeSystems/BDMedicationForm.fsh

@@ -30,12 +30,11 @@ Description: "Medication dose form codes according to CCDS guideline"
     "Low-viscosity liquid topical dosage form for external application."
 
 
-// ---------------------------
+// // ---------------------------
-// ValueSet for BD Medication Dose Forms
+// // ValueSet for BD Medication Dose Forms
-// ---------------------------
+// // ---------------------------
-ValueSet: BDMedicationDoseFormVS
+// ValueSet: BDMedicationDoseFormVS
-Id: bd-dose-form-valueset
+// Id: bd-dose-form-valueset
-Title: "Bangladesh Medication Dose Form ValueSet"
+// Title: "Bangladesh Medication Dose Form ValueSet"
-Description: "Medication dose form value set according to CCDS guideline"
+// Description: "Medication dose form value set according to CCDS guideline"
-* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/bd-dose-form-valueset"
+// * ^url = "https://fhir.dghs.gov.bd/core/ValueSet/bd-dose-form-valueset"
-* include codes from system BDMedicationDoseForm

input/fsh/codeSystems/ICD11MMSCS.fsh

@@ -17,7 +17,7 @@ The authoritative content is maintained by the World Health Organization.
 In Bangladesh, runtime code validation and lookup are delegated to the
 national OCL terminology server at https://tr.ocl.dghs.gov.bd.
 
-Supported operations (use `system=` parameter, not `url=`):
+Supported operations (use system= parameter, not url=):
   - $validate-code: https://tr.ocl.dghs.gov.bd/api/fhir/CodeSystem/$validate-code?system=http://id.who.int/icd/release/11/mms&code={code}
   - $lookup:        https://tr.ocl.dghs.gov.bd/api/fhir/CodeSystem/$lookup?system=http://id.who.int/icd/release/11/mms&code={code}
 

input/fsh/examples/BDEncounterExample.fsh

@@ -0,0 +1,25 @@
+Instance: BDEncounterExample
+InstanceOf: BDEncounter
+Usage: #example
+Title: "Example of a Bangladesh Patient Encounter"
+Description: "An example of an outpatient encounter for a Bangladesh patient."
+
+* identifier[0].value = "ENC-2023-001"
+* identifier[0].system = "https://fhir.dghs.gov.bd/core/identifier/encounter"
+
+* status = #finished
+
+// Must use a code from your BDEncounterClassSubsetVS
+// Example using standard HL7 ActCode for ambulatory (outpatient)
+* class = http://terminology.hl7.org/CodeSystem/v3-ActCode#AMB "ambulatory"
+
+// Reference the patient example we created in the previous step
+* subject = Reference(BDPatientExample)
+
+// serviceProvider is 1..1 in your profile
+* serviceProvider = Reference(BDOrganizationExample) 
+
+// participant and participant.period are 1..1
+* participant[0].individual = Reference(BDPractitionerExample)
+* participant[0].period.start = "2023-10-27T10:00:00Z"
+* participant[0].period.end = "2023-10-27T10:30:00Z"

input/fsh/examples/BDMedicationExample.fsh

@@ -0,0 +1,33 @@
+Instance: BDMedicationExample
+InstanceOf: BDMedication
+Title: "Medication Example — Marvelous Fe (Combination Drug)"
+Description: """
+Example BDMedication instance for Marvelous Fe, a combination drug containing
+ferrous sulphate and folic acid. Demonstrates multi-ingredient handling with
+ICD-11 MMS substance codes populated from OCL Has-active-ingredient mappings.
+Dose form coded using EDQM Standard Terms.
+"""
+Usage: #example
+
+* code.coding[0].system = "https://dgda.gov.bd/drug-registry"
+* code.coding[0].code = #353-0026-039--marvelous-fe
+* code.coding[0].display = "Marvelous Fe"
+* code.text = "Marvelous Fe"
+
+* form.coding[0].system = "http://standardterms.edqm.eu"
+* form.coding[0].code = #10219000
+* form.coding[0].display = "Tablet"
+
+// Ingredient 1: Ferrous Sulphate → ICD-11 XM substance code
+* ingredient[0].itemCodeableConcept.coding[0].system = "http://id.who.int/icd/release/11/mms"
+* ingredient[0].itemCodeableConcept.coding[0].code = #XM3SQ1
+* ingredient[0].itemCodeableConcept.coding[0].display = "Ferrous sulphate"
+* ingredient[0].itemCodeableConcept.text = "Ferrous sulphate"
+* ingredient[0].isActive = true
+
+// Ingredient 2: Folic Acid → ICD-11 XM substance code
+* ingredient[1].itemCodeableConcept.coding[0].system = "http://id.who.int/icd/release/11/mms"
+* ingredient[1].itemCodeableConcept.coding[0].code = #XM7R82
+* ingredient[1].itemCodeableConcept.coding[0].display = "Folic acid"
+* ingredient[1].itemCodeableConcept.text = "Folic acid"
+* ingredient[1].isActive = true

input/fsh/examples/BDMedicationRequestExample.fsh

@@ -0,0 +1,41 @@
+Instance: BDMedicationRequestExample
+InstanceOf: BDMedicationRequest
+Title: "Medication Request Example — Marvelous Fe Prescription"
+Description: """
+Example BDMedicationRequest instance prescribing Marvelous Fe. Demonstrates
+the full prescription chain: BDMedicationRequest → BDMedication → DGDA code
+→ ICD-11 substance ingredients. Route of administration coded using HL7 v3
+RouteOfAdministration.
+"""
+Usage: #example
+
+* identifier[0].system = "https://fhir.dghs.gov.bd/identifier/prescription"
+* identifier[0].value = "RX-2024-BD-000001"
+
+* status = #active
+* intent = #order
+
+* medicationReference = Reference(BDMedicationExample)
+
+* subject = Reference(BDPatientExample)
+* subject.display = "Example Patient"
+
+* encounter = Reference(BDEncounterExample)
+* encounter.display = "Example Outpatient Encounter"
+
+* authoredOn = "2024-11-01T10:30:00+06:00"
+
+* requester = Reference(BDPractitionerExample)
+* requester.display = "Example Practitioner"
+
+* dosageInstruction[0].text = "Take 1 tablet daily after meals"
+* dosageInstruction[0].timing.repeat.frequency = 1
+* dosageInstruction[0].timing.repeat.period = 1
+* dosageInstruction[0].timing.repeat.periodUnit = #d
+* dosageInstruction[0].route.coding[0].system = "http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration"
+* dosageInstruction[0].route.coding[0].code = #PO
+* dosageInstruction[0].route.coding[0].display = "Swallow, oral"
+* dosageInstruction[0].doseAndRate[0].doseQuantity.value = 1
+* dosageInstruction[0].doseAndRate[0].doseQuantity.unit = "tablet"
+* dosageInstruction[0].doseAndRate[0].doseQuantity.system = "http://unitsofmeasure.org"
+* dosageInstruction[0].doseAndRate[0].doseQuantity.code = #{tbl}

input/fsh/examples/BDOrganizationExample.fsh

@@ -0,0 +1,22 @@
+Instance: BDOrganizationExample
+InstanceOf: BDOrganization
+Usage: #example
+Title: "Example of a Bangladesh Organization"
+Description: "Example for DMCH using the Facility Code 10000033"
+
+// Strictly following 'identifier 1..* MS' from your profile
+* identifier[0].value = "10000033"
+* identifier[0].system = "http://hrm.dghs.gov.bd/facilities/code" // Using a generic DGHS system
+* identifier[0].type = http://terminology.hl7.org/CodeSystem/v2-0203#FI "Facility ID"
+
+* name = "Dhaka Medical College Hospital"
+
+// Standard FHIR Address fields (No 'division' as a top-level field)
+* address[0].line = "100 Ramna"
+* address[0].city = "Dhaka"
+* address[0].district = "Dhaka"
+* address[0].country = "BD"
+
+// To include Division without a 'does not exist' error, use the extension syntax:
+* address[0].extension[0].url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-division"
+* address[0].extension[0].valueCodeableConcept = https://fhir.dghs.gov.bd/core/CodeSystem/bd-geocodes#30 "Dhaka"

input/fsh/examples/BDPatientExample.fsh

@@ -0,0 +1,35 @@
+Instance: BDPatientExample
+InstanceOf: BDPatient
+Usage: #example
+Title: "Example of a Bangladesh Patient"
+Description: "A minimal example for a patient satisfying name translations and address requirements."
+
+// Required Name with English and Bangla Translations using separate extensions
+* name[0].use = #official
+* name[0].text = "Abul Kashem"
+* name[0].text.extension[nameEn].valueString = "Abul Kashem"
+* name[0].text.extension[nameBn].valueString = "আবুল কাশেম"
+
+// Required Gender and BirthDate
+* gender = #male
+* birthDate = "1985-05-20"
+
+// Identifier Slice: NID Example
+* identifier[NID].type.coding.system = "https://fhir.dghs.gov.bd/core/CodeSystem/bd-identifier-type"
+* identifier[NID].type.coding.code = #NID
+* identifier[NID].type.text = "Organization identifier"
+* identifier[NID].value = "1234567890"
+
+// Address with required extensions
+* address[0].use = #home
+* address[0].district = "3026"
+* address[0].country = "BD"
+
+// Division extension
+* address[0].extension[division].valueCodeableConcept = https://fhir.dghs.gov.bd/core/CodeSystem/bd-geocodes#30 "Dhaka"
+
+// Upazilla extension
+* address[0].extension[upazilla].valueCodeableConcept = https://fhir.dghs.gov.bd/core/CodeSystem/bd-geocodes#10040028 "Dhamrai"
+
+// Optional Religion Extension
+* extension[religion].valueCodeableConcept = https://fhir.dghs.gov.bd/core/CodeSystem/bd-religions#1 "Islam"

input/fsh/examples/BDPractitionerExample.fsh

@@ -0,0 +1,25 @@
+Instance: BDPractitionerExample
+InstanceOf: BDPractitioner
+Usage: #example
+Title: "Example of a Bangladesh Practitioner"
+Description: "A licensed physician example for the Bangladesh HIE."
+
+// Required Identifier (1..* MS)
+// Using BMDC (Bangladesh Medical & Dental Council) registration number
+* identifier[0].system = "https://fhir.dghs.gov.bd/core/identifier/bmdc-registration"
+* identifier[0].value = "A-12345"
+* identifier[0].type = http://terminology.hl7.org/CodeSystem/v2-0203#MD "Medical License number"
+
+// Recommended Name
+* name[0].use = #official
+* name[0].family = "Ahmed"
+* name[0].given[0] = "Tanvir"
+* name[0].prefix[0] = "Dr."
+
+// Contact Information
+* telecom[0].system = #phone
+* telecom[0].value = "+8801712345678"
+* telecom[0].use = #work
+
+// Gender (Commonly used in health records)
+* gender = #male

input/fsh/extensions/BDNameBn.fsh

@@ -0,0 +1,6 @@
+Extension: BDNameBn
+Id: bd-name-bn
+Title: "Bangla Name"
+Description: "Bangla translation of the patient name"
+Context: HumanName.text
+* value[x] only string

input/fsh/extensions/BDNameEn.fsh

@@ -0,0 +1,6 @@
+Extension: BDNameEn
+Id: bd-name-en
+Title: "English Name"
+Description: "English translation of the patient name"
+Context: HumanName.text
+* value[x] only string

input/fsh/extensions/division.fsh

@@ -6,5 +6,5 @@ Description: "BD Division"
 Context: Address
 
 
-* value[x] only string
+* value[x] only CodeableConcept
-* value[x] from BDDivisionsVS
+* valueCodeableConcept from BDDivisionsVS (required)

input/fsh/extensions/icd11ClusterExpression.fsh

@@ -0,0 +1,68 @@
+// ============================================================
+// icd11ClusterExpression.fsh
+// Extension for ICD-11 postcoordinated cluster expressions
+// Context: Coding (broad — usable across all ICD-11 coded elements)
+// ============================================================
+
+Extension: ICD11ClusterExpression
+Id: icd11-cluster-expression
+Title: "ICD-11 Cluster Expression"
+Description: """
+Carries a postcoordinated ICD-11 cluster expression as a single string
+on a Coding element where the stem code alone is insufficient to fully
+represent the clinical concept.
+
+A cluster expression combines a stem code with one or more satellite
+codes using the & operator (combination) or / operator (specificity).
+Example: NC72.Z&XK8G&XJ7ZH&XJ7YM
+  - NC72.Z  — stem: Fracture of femur, unspecified
+  - XK8G    — satellite: laterality
+  - XJ7ZH   — satellite: fracture subtype
+  - XJ7YM   — satellite: fracture open or closed
+
+Usage rules:
+  - SHALL only be present when the expression contains at least one
+    satellite code joined by & or / operators.
+  - Single stem codes SHALL be represented in Coding.code only and
+    validated via OCL $validate-code. The cluster validator at
+    https://icd11.dghs.gov.bd/cluster/validate explicitly rejects
+    stem-only expressions.
+  - The stem code in Coding.code SHALL match the leading stem code
+    in this expression string.
+  - Satellite codes in the cluster expression are exempt from the
+    Diagnosis/Finding class restriction that applies to stem codes
+    in Condition.code.
+  - Cluster expressions SHALL be validated against the Bangladesh
+    ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate
+    prior to submission to the HIE.
+
+Cluster validator endpoint:
+  POST https://icd11.dghs.gov.bd/cluster/validate
+  Body: { "expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM" }
+
+This extension is not MustSupport and is not mandatory. It is present
+only when postcoordination is clinically required. Cluster expressions
+are typically sourced from the WHO Electronic Coding Tool (ECT) at the
+point of care.
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression"
+* ^status = #active
+* ^experimental = false
+* ^publisher = "Directorate General of Health Services (DGHS), MoHFW, Bangladesh"
+* ^contact.name = "DGHS Health Informatics Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^context[+].type = #element
+* ^context[=].expression = "Coding"
+
+* value[x] only string
+* valueString 1..1
+* valueString ^short = "ICD-11 postcoordinated cluster expression string"
+* valueString ^definition = """
+The full postcoordinated cluster expression, including the stem code and
+all satellite codes joined by & or / operators. Example:
+NC72.Z&XK8G&XJ7ZH&XJ7YM. The stem code in this string SHALL match
+Coding.code on the parent Coding element.
+"""

input/fsh/extensions/upazilla.fsh

@@ -6,5 +6,5 @@ Description: "BD Upazilla"
 Context: Address
 
 
-* value[x] only string
+* value[x] only CodeableConcept
-* value[x] from BDUpazillasVS
+* valueCodeableConcept from BDUpazillasVS (required)

input/fsh/immunization.json

@@ -1,39 +0,0 @@
-{
-  "resourceType": "StructureDefinition",
-<<<<<<< HEAD
-  "id": "bd-Immunization",
-  "url": "http://example.org/StructureDefinition/bd-Immunization",
-  "version": "1.0.0",
-  "name": "BDImmunizationProfile",
-  "title": "Immunization Profile for Bangladesh",
-  "description": "Bangladesh Immunization Profile",
-=======
-  "id": "bd-immunization",
-  "url": "https://fhir.dghs.gov.bd/core/identifier/bd-immunization",
-  "version": "1.0.0",
-  "name": "BDImmunizationProfile",
-  "title": "Patient Immunization Profile for Bangladesh",
-  "description": "Patients Immunization Bangladesh Standard",
->>>>>>> 1c45affa520e64b3b9efc307d9116ff138171fa5
-  "fhirVersion": "4.0.1",
-  "kind": "resource",
-  "abstract": false,
-  "type": "Immunization",
-  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Immunization",
-  "derivation": "constraint",
-  "differential": {
-    "element": [
-      {
-        "id": "Immunization.identifier",
-        "path": "Immunization.identifier",
-<<<<<<< HEAD
-        "short": "Unique identifier",
-=======
-        "short": "Identifier",
->>>>>>> 1c45affa520e64b3b9efc307d9116ff138171fa5
-        "definition": "Unique identifier for the vaccination event",
-        "min": 1
-      }
-    ]
-  }
-}

input/fsh/namingSystems/ICD11MMSNamingSystem.fsh

@@ -0,0 +1,63 @@
+// ============================================================
+// ICD11MMSNamingSystem.fsh
+// NamingSystem for ICD-11 MMS in the Bangladesh national context
+// Canonical authority: WHO
+// National resolver: OCL at https://tr.ocl.dghs.gov.bd
+// ============================================================
+
+Instance: icd11-mms-bd
+InstanceOf: NamingSystem
+Usage: #definition
+Title: "ICD-11 MMS NamingSystem — Bangladesh"
+Description: """
+Declares the ICD-11 Mortality and Morbidity Statistics (MMS) coding system
+as a known and supported terminology within the Bangladesh national health
+information infrastructure.
+
+Canonical system URI: http://id.who.int/icd/release/11/mms
+Canonical authority: World Health Organization (WHO)
+
+Preferred code form: short stem codes (e.g. 1A00, NC72.Z).
+Linearization URIs are not used as code identifiers in this IG.
+
+National terminology resolver (OCL):
+  https://tr.ocl.dghs.gov.bd
+
+Supported OCL operations (use system= parameter, not url=):
+  - $validate-code: https://tr.ocl.dghs.gov.bd/api/fhir/CodeSystem/$validate-code
+      ?system=http://id.who.int/icd/release/11/mms&code={code}
+  - $lookup: https://tr.ocl.dghs.gov.bd/api/fhir/CodeSystem/$lookup
+      ?system=http://id.who.int/icd/release/11/mms&code={code}
+
+$expand is not supported — known OCL limitation.
+
+Version 2025-01 is active in the national OCL instance with 36,941
+imported concepts. The OCL resolver is an internal national service;
+vendors do not interact with it directly. All vendor submissions are
+validated at the HIE boundary via the Bangladesh ICD-11 Cluster Validator
+at https://icd11.dghs.gov.bd/cluster/validate.
+"""
+
+* name = "ICD11MMSBangladesh"
+* status = #active
+* kind = #codesystem
+* date = "2025-01-01"
+* publisher = "Directorate General of Health Services (DGHS), MoHFW, Bangladesh"
+* contact.name = "DGHS Health Informatics Unit"
+* contact.telecom.system = #url
+* contact.telecom.value = "https://dghs.gov.bd"
+* jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* responsible = "World Health Organization (WHO)"
+
+// Primary identifier — canonical system URI (WHO authority)
+* uniqueId[+].type = #uri
+* uniqueId[=].value = "http://id.who.int/icd/release/11/mms"
+* uniqueId[=].preferred = true
+* uniqueId[=].comment = "Canonical ICD-11 MMS system URI. Canonical authority is WHO."
+* uniqueId[=].period.start = "2025-01-01"
+
+// Secondary identifier — national OCL source locator (machine-discoverable, not canonical)
+* uniqueId[+].type = #uri
+* uniqueId[=].value = "https://tr.ocl.dghs.gov.bd/orgs/MoHFW/sources/ICD-11-MMS/"
+* uniqueId[=].preferred = false
+* uniqueId[=].comment = "National terminology resolver — Bangladesh OCL instance. Not the canonical system URI."

input/fsh/profile/BDConditionProfile.fsh

@@ -0,0 +1,65 @@
+// ============================================================
+// BDConditionProfile.fsh
+// BD-Core Condition profile with mandatory ICD-11 MMS stem slice
+// Binding: Diagnosis and Finding class concepts only
+// Runtime enforcement via OCL ValueSet $validate-code
+// ============================================================
+
+Profile: BDConditionProfile
+Parent: Condition
+Id: bd-condition
+Title: "BD Core Condition Profile (ICD-11)"
+Description: """
+Condition resource coded with ICD-11 MMS, restricted to Diagnosis and
+Finding class concepts. Defined in the Bangladesh Core FHIR Implementation
+Guide (BD-Core-FHIR-IG) published by DGHS/MoHFW.
+"""
+
+* code 1..1 MS
+* code from bd-condition-icd11-diagnosis-valueset (required)
+* code ^comment = """
+Condition.code SHALL contain at least one coding conforming to the
+coding[stem] slice with system = http://id.who.int/icd/release/11/mms.
+
+Stem code rules:
+  - The stem code SHALL be a Diagnosis or Finding class ICD-11 MMS concept.
+  - This restriction is enforced at runtime via OCL ValueSet $validate-code
+    against the Bangladesh ICD-11 MMS Condition ValueSet.
+  - Stem-only codes SHALL be validated via OCL $validate-code.
+  - Substance, Organism, Device, Anatomy, and Misc class concepts SHALL NOT
+    appear as standalone stem codes in Condition.code.
+
+Cluster expression rules:
+  - When a concept requires postcoordination, the full cluster expression
+    SHALL be carried in the icd11-cluster-expression extension on coding[stem].
+  - The icd11-cluster-expression extension SHALL only be present when the
+    expression contains at least one satellite code joined by & or / operators.
+  - Satellite codes in the cluster expression are exempt from the
+    Diagnosis/Finding class restriction.
+  - Cluster expressions SHALL be validated against the Bangladesh ICD-11
+    Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate
+    prior to submission to the HIE.
+
+Additional local codings are permitted alongside the mandatory ICD-11 stem
+(slicing is open). Cluster expressions are typically sourced from the WHO
+Electronic Coding Tool (ECT) at the point of care.
+"""
+
+* code.coding ^slicing.discriminator.type = #value
+* code.coding ^slicing.discriminator.path = "system"
+* code.coding ^slicing.rules = #open
+* code.coding ^slicing.description = "Slice requiring exactly one ICD-11 MMS stem code. Additional local codings permitted."
+
+* code.coding contains stem 1..1
+* code.coding[stem] ^short = "Mandatory ICD-11 MMS stem code"
+* code.coding[stem] ^definition = """
+Exactly one ICD-11 MMS stem code is required. The stem code SHALL be a
+Diagnosis or Finding class concept. When the condition requires
+postcoordination, the full cluster expression is carried in the
+icd11-cluster-expression extension on this coding element.
+"""
+* code.coding[stem].system 1..1
+* code.coding[stem].system = "http://id.who.int/icd/release/11/mms" (exactly)
+* code.coding[stem].code 1..1
+* code.coding[stem].extension contains
+    https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression named clusterExpression 0..1

input/fsh/profile/BDEncounter.fsh

@@ -1,5 +1,5 @@
 
-Profile:     BDEncounterProfile
+Profile:     BDEncounter
 Id:          bd-encounter
 Parent:      Encounter
 Title:       "Encounter Profile for Bangladesh"

input/fsh/profile/BDImmunization.fsh

@@ -35,11 +35,11 @@ Description: "Bangladesh Immunization Profile"
 
 * patient 1..1
 * patient ^definition = "The patient receiving the vaccine"
-* patient only Reference(BDPatientProfile)
+* patient only Reference(BDPatient)
 
 * encounter 1..1
 * encounter ^definition = "Encounter during which vaccine was administered"
-* encounter only Reference(BDEncounterProfile)
+* encounter only Reference(BDEncounter)
 
 * occurrence[x] 1..1
 

input/fsh/profile/BDLabPanelObservation.fsh

@@ -0,0 +1,77 @@
+Profile:     BDLabPanelObservationProfile
+Id:          bd-lab-panel-observation
+Parent:      bd-observation
+Title:       "Bangladesh Laboratory Panel Observation"
+Description: """
+Profile for laboratory panel (order-level) Observations in Bangladesh.
+Represents an ordered laboratory test panel (e.g. CBC, LFT, RFT) as the
+parent Observation in a hasMember hierarchy.
+
+Usage:
+  - Observation.code is the panel/order code (from BD LOINC Lab Panels ValueSet)
+  - Observation.hasMember references individual result Observations
+    (bd-lab-result-observation) for each component
+  - Observation.value[x] is prohibited — panels do not carry a direct result value
+  - Observation.category is fixed to 'laboratory'
+
+FHIR hasMember pattern:
+  DiagnosticReport.result --> bd-lab-panel-observation
+                                  └── hasMember --> bd-lab-result-observation (x N)
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-panel-observation"
+* ^version = "0.1.0"
+* ^status = #draft
+
+// ── Identifier ────────────────────────────────────────────────────────────
+// Lab panels must carry an identifier (accession number or order ID).
+* identifier 1..* MS
+* identifier.value 1..1
+
+// ── Category ──────────────────────────────────────────────────────────────
+// Fixed to 'laboratory' for all lab panel observations.
+* category = http://terminology.hl7.org/CodeSystem/observation-category#laboratory
+* category ^definition = "Fixed to 'laboratory' for laboratory panel observations"
+
+// ── Code ──────────────────────────────────────────────────────────────────
+// Bound to BD LOINC Lab Panels ValueSet — orderable panel codes only.
+* code 1..1 MS
+* code from https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-panels (required)
+* code ^definition = "LOINC panel/order code for this laboratory panel"
+* code ^comment = "E.g. 58410-2 CBC panel, 24323-8 Comprehensive metabolic panel"
+
+// ── Status ────────────────────────────────────────────────────────────────
+// Restrict to statuses relevant to lab reporting.
+* status from http://hl7.org/fhir/ValueSet/observation-status (required)
+
+// ── Effective ─────────────────────────────────────────────────────────────
+// When the panel was performed — required for lab context.
+* effective[x] 1..1 MS
+* effective[x] only dateTime or Period
+* effectiveDateTime ^definition = "Date/time the laboratory panel was performed"
+
+// ── Value[x] ──────────────────────────────────────────────────────────────
+// Panels do not carry a direct result value — results are in hasMember children.
+* value[x] 0..0
+
+// ── hasMember ─────────────────────────────────────────────────────────────
+// Must reference at least one component result Observation.
+// Typed to bd-lab-result-observation.
+* hasMember 1..* MS
+* hasMember only Reference(BDLabResultObservationProfile)
+* hasMember ^definition = "References to individual component result Observations for this panel"
+* hasMember ^comment = "Each hasMember entry is a bd-lab-result-observation"
+
+// ── derivedFrom ───────────────────────────────────────────────────────────
+// Panels are not derived from other observations — prohibited at this level.
+* derivedFrom 0..0
+
+// ── Specimen ──────────────────────────────────────────────────────────────
+// SHOULD be present for laboratory panels per IPS alignment.
+* specimen 0..1 MS
+* specimen ^definition = "Specimen collected for this laboratory panel"
+* specimen ^comment = "Should be present when specimen information is available"
+
+// ── Note ──────────────────────────────────────────────────────────────────
+* note 0..* MS
+* note ^definition = "Comments about the laboratory panel"

input/fsh/profile/BDLabReport.fsh

@@ -0,0 +1,122 @@
+Profile:     BDLabReportProfile
+Id:          bd-lab-report
+Parent:      DiagnosticReport
+Title:       "Bangladesh Laboratory Report"
+Description: """
+Profile for laboratory DiagnosticReport in Bangladesh, aligned with IPS
+(International Patient Summary) DiagnosticReport pattern.
+
+Usage:
+  - Represents a complete laboratory report for a patient encounter
+  - DiagnosticReport.result references panel-level Observations
+    (bd-lab-panel-observation) or standalone result Observations
+    (bd-lab-result-observation) where no panel grouping exists
+  - DiagnosticReport.code is fixed to LOINC 11502-2 (Laboratory report)
+  - specimen is SHOULD (MS, 0..*)
+
+Report structure:
+  bd-lab-report (DiagnosticReport)
+      ├── result --> bd-lab-panel-observation
+      │                 └── hasMember --> bd-lab-result-observation (x N)
+      └── result --> bd-lab-result-observation  (standalone, no panel)
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-report"
+* ^version = "0.1.0"
+* ^status = #draft
+
+// ── Identifier ────────────────────────────────────────────────────────────
+// Lab reports must carry an accession number or report ID.
+* identifier 1..* MS
+* identifier.value 1..1
+
+// ── Status ────────────────────────────────────────────────────────────────
+* status 1..1
+* status from http://hl7.org/fhir/ValueSet/diagnostic-report-status (required)
+* status ^definition = "Status of the laboratory report"
+* status ^comment = "E.g. registered, partial, preliminary, final, amended, corrected"
+
+// ── Category ──────────────────────────────────────────────────────────────
+// Fixed to LAB (laboratory) category.
+* category 1..* MS
+* category = http://terminology.hl7.org/CodeSystem/v2-0074#LAB "Laboratory"
+* category ^definition = "Fixed to 'LAB' for laboratory diagnostic reports"
+
+// ── Code ──────────────────────────────────────────────────────────────────
+// Fixed to LOINC 11502-2 (Laboratory report) — IPS-aligned.
+* code 1..1 MS
+* code = http://loinc.org#11502-2 "Laboratory report"
+* code ^definition = "Fixed to LOINC 11502-2 — Laboratory report"
+
+// ── Subject ───────────────────────────────────────────────────────────────
+* subject 1..1 MS
+* subject only Reference(Patient)
+* subject.reference 1..1 MS
+* subject.display 1..1 MS
+* subject ^definition = "Reference to the Patient this report is about"
+
+// ── Encounter ─────────────────────────────────────────────────────────────
+* encounter 1..1 MS
+* encounter.reference 1..1 MS
+* encounter ^definition = "Reference to the Encounter during which this report was ordered"
+
+// ── Effective ─────────────────────────────────────────────────────────────
+// When the report was clinically relevant — required for lab context.
+* effective[x] 1..1 MS
+* effective[x] only dateTime or Period
+* effectiveDateTime ^definition = "Date/time the specimen was collected or the report period"
+
+// ── Issued ────────────────────────────────────────────────────────────────
+// Date/time the report was released — required for lab reports.
+* issued 1..1 MS
+* issued ^definition = "Date/time the report was issued by the laboratory"
+
+// ── Performer ─────────────────────────────────────────────────────────────
+// Who performed the laboratory test (laboratory organization or practitioner).
+// Kept flexible — may be Organization, Practitioner, or PractitionerRole.
+* performer 1..* MS
+* performer ^definition = "Laboratory or practitioner who performed the test"
+* performer ^comment = "Typically the laboratory Organization. May also include the responsible Practitioner."
+
+// ── Results Interpreter ───────────────────────────────────────────────────
+// Who interpreted the results (clinician, pathologist).
+// Optional but MustSupport — include when a formal interpretation was made.
+* resultsInterpreter 0..* MS
+* resultsInterpreter ^definition = "Clinician or pathologist who interpreted the laboratory results"
+* resultsInterpreter ^comment = "Include when a formal interpretation or authorisation was made by a named clinician."
+
+// ── Specimen ──────────────────────────────────────────────────────────────
+// SHOULD be present per IPS alignment — MustSupport, optional cardinality.
+* specimen 0..* MS
+* specimen ^definition = "Specimen(s) used for this laboratory report"
+* specimen ^comment = "Should be present when specimen information is available. IPS alignment: SHOULD."
+
+// ── Result ────────────────────────────────────────────────────────────────
+// References panel-level Observations or standalone result Observations.
+// At least one result is required for a meaningful report.
+* result 1..* MS
+* result only Reference(BDLabPanelObservationProfile or BDLabResultObservationProfile)
+* result ^definition = "References to Observation resources that are part of this report"
+* result ^comment = """
+Use BDLabPanelObservationProfile for ordered panels (CBC, LFT, RFT, etc.)
+where individual results are grouped under a panel using hasMember.
+Use BDLabResultObservationProfile directly for standalone results
+that are not part of a named panel.
+"""
+
+// ── Conclusion ────────────────────────────────────────────────────────────
+// Free-text clinical interpretation of the overall report.
+* conclusion 0..1 MS
+* conclusion ^definition = "Clinical interpretation or summary of the laboratory report"
+
+// ── Conclusion Code ───────────────────────────────────────────────────────
+// Coded clinical finding — may reference ICD-11 diagnosis codes.
+* conclusionCode 0..* MS
+* conclusionCode ^definition = "Coded representation of the clinical conclusion"
+* conclusionCode ^comment = "May use ICD-11 MMS codes consistent with bd-condition-icd11-diagnosis-valueset"
+
+// ── Presented Form ────────────────────────────────────────────────────────
+// Attach the original PDF or HL7 CDA report if available.
+* presentedForm 0..* MS
+* presentedForm ^definition = "Entire report as issued — e.g. PDF attachment"
+* presentedForm ^comment = "Include the original report document when available"

input/fsh/profile/BDLabResultObservation.fsh

@@ -0,0 +1,104 @@
+Profile:     BDLabResultObservationProfile
+Id:          bd-lab-result-observation
+Parent:      bd-observation
+Title:       "Bangladesh Laboratory Result Observation"
+Description: """
+Profile for individual laboratory result (component-level) Observations
+in Bangladesh. Represents a single test result within a laboratory panel
+(e.g. Haemoglobin within a CBC panel).
+
+Usage:
+  - Observation.code is the result/component code (from BD LOINC Lab Results ValueSet)
+  - Observation.value[x] is required — every leaf result must carry a value
+  - Observation.hasMember is prohibited — leaf results cannot group further
+  - Observation.derivedFrom references the parent panel Observation
+  - Observation.category is fixed to 'laboratory'
+
+FHIR hasMember pattern:
+  bd-lab-panel-observation
+      └── hasMember --> bd-lab-result-observation (this profile)
+
+Coded results (Ord/Nom scale):
+  Use valueCodeableConcept with codes from BD LOINC Answer Lists ValueSet.
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-lab-result-observation"
+* ^version = "0.1.0"
+* ^status = #draft
+
+// ── Identifier ────────────────────────────────────────────────────────────
+// Result observations carry the accession number or result ID.
+* identifier 1..* MS
+* identifier.value 1..1
+
+// ── Category ──────────────────────────────────────────────────────────────
+// Fixed to 'laboratory' for all lab result observations.
+* category = http://terminology.hl7.org/CodeSystem/observation-category#laboratory
+* category ^definition = "Fixed to 'laboratory' for laboratory result observations"
+
+// ── Code ──────────────────────────────────────────────────────────────────
+// Bound to BD LOINC Lab Results ValueSet — leaf result codes only.
+* code 1..1 MS
+* code from https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results (required)
+* code ^definition = "LOINC result/component code for this individual laboratory result"
+* code ^comment = "E.g. 718-7 Hemoglobin, 2160-0 Creatinine"
+
+// ── Status ────────────────────────────────────────────────────────────────
+* status from http://hl7.org/fhir/ValueSet/observation-status (required)
+
+// ── Effective ─────────────────────────────────────────────────────────────
+* effective[x] 1..1 MS
+* effective[x] only dateTime or Period
+* effectiveDateTime ^definition = "Date/time the result was obtained"
+
+// ── Value[x] ──────────────────────────────────────────────────────────────
+// Required — every leaf result must carry a value.
+* value[x] 1..1 MS
+* value[x] only Quantity or CodeableConcept
+* value[x] ^definition = "The actual result value for this laboratory test"
+
+// Numeric results (Qn scale) — UCUM units required
+* valueQuantity MS
+* valueQuantity.value 1..1
+* valueQuantity.unit 1..1
+* valueQuantity.system 1..1
+* valueQuantity.system = "http://unitsofmeasure.org"
+* valueQuantity.code 1..1
+* valueQuantity ^comment = "Use for quantitative (Qn scale) results. Units must be UCUM."
+
+// Coded results (Ord/Nom scale) — bound to LOINC Answer Lists
+* valueCodeableConcept MS
+* valueCodeableConcept from https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists (required)
+* valueCodeableConcept ^comment = "Use for ordinal or nominal (Ord/Nom scale) results."
+
+// ── hasMember ─────────────────────────────────────────────────────────────
+// Leaf results cannot group further observations.
+* hasMember 0..0
+
+// ── derivedFrom ───────────────────────────────────────────────────────────
+// References the parent panel Observation.
+* derivedFrom 0..* MS
+* derivedFrom only Reference(BDLabPanelObservationProfile)
+* derivedFrom ^definition = "Reference to the parent panel Observation this result belongs to"
+
+// ── Interpretation ────────────────────────────────────────────────────────
+// Strongly recommended for lab results — High, Low, Normal, etc.
+* interpretation 0..* MS
+* interpretation from http://hl7.org/fhir/ValueSet/observation-interpretation (extensible)
+* interpretation ^definition = "Clinical interpretation of the result value"
+* interpretation ^comment = "E.g. H (High), L (Low), N (Normal), A (Abnormal)"
+
+// ── Reference Range ───────────────────────────────────────────────────────
+* referenceRange 0..* MS
+* referenceRange ^definition = "Normal reference range for this result"
+* referenceRange ^comment = "Should be present when reference ranges are known"
+
+// ── Specimen ──────────────────────────────────────────────────────────────
+// May reference the same specimen as the parent panel.
+* specimen 0..1 MS
+* specimen ^definition = "Specimen used for this result observation"
+* specimen ^comment = "Should be consistent with the parent panel specimen"
+
+// ── Note ──────────────────────────────────────────────────────────────────
+* note 0..* MS
+* note ^definition = "Comments about this individual result"

input/fsh/profile/BDMedication.fsh

@@ -1,17 +1,76 @@
-// @Name: Profile
-// @Description: Example of a profile of the Medication resource. This example includes a few of the most commonly used constraints and documentation features of FHIR profiles.
-
 Profile: BDMedication
 Id: bd-medication
 Parent: Medication
-Title: "Medication Profile for Bangladesh-V2"
+Title: "Medication Profile for Bangladesh"
-Description: "Profile of Medication Bangladesh Standard V2"
+Description: """
+Profile of the Medication resource for the Bangladesh National Health Information
+Exchange (HIE). Drug products are coded using the DGDA Drug Registry maintained
+by the Drug Registration Authority of Bangladesh and served via the national OCL
+terminology server at https://tr.ocl.dghs.gov.bd.
 
-* form 1..1 MS
+Ingredient coding uses ICD-11 MMS substance codes (XM-prefix) to support
-* form from BDMedicationDoseFormVS
+International Patient Summary (IPS) generation and cross-border data exchange.
+Ingredient data is system-populated from OCL Has-active-ingredient mappings and
+is not required to be entered manually by clinicians.
+
+Combination drugs are supported via the repeating ingredient element.
+Unmatched ingredients (not yet mapped to ICD-11 substances) may be represented
+using ingredient.itemCodeableConcept.text without a coded value.
+
+Dose form is optional and should be coded using EDQM Standard Terms when
+populated. Dose form is derivable from the DGDA drug concept via OCL lookup.
+A DGDA plain text dose form to EDQM code mapping is planned for a future
+IG version.
+"""
 
 * code 1..1 MS
-* code from BDMedicationVS
+* code from BDDGDADrugsVS (required)
+* code ^short = "DGDA registered drug product code"
+* code ^definition = """
+The DGDA drug registry code identifying the finished pharmaceutical product.
+Concept ID format: {DAR-number}--{trade-name-slug}
+Example: 353-0026-039--marvelous-fe
+"""
+* code.text 1..1 MS
+* code.text ^short = "Trade name of the drug product"
+* code.text ^definition = """
+The trade name of the drug product as registered with DGDA. Mandatory for
+human readability in IPS documents and cross-border data exchange scenarios.
+"""
 
-* ingredient 1..* MS
+* form 0..1 MS
-* ingredient.strength 1..1 MS
+* form from BDMedicationDoseFormVS (preferred)
+* form ^short = "Pharmaceutical dose form — EDQM Standard Terms (optional)"
+* form ^definition = """
+The pharmaceutical dose form of the drug product. Optional in this profile
+as dose form is carried as plain text in the DGDA drug concept and is
+derivable via OCL lookup. When populated, EDQM Standard Terms codes served
+from the national OCL terminology server should be used.
+A DGDA dose form to EDQM mapping is planned for a future IG version.
+"""
+
+* ingredient MS
+* ingredient ^short = "Active ingredient(s) of the drug product"
+* ingredient ^definition = """
+Active pharmaceutical ingredients of the drug product, coded using ICD-11 MMS
+substance codes (XM-prefix). Populated automatically by clinical systems via
+OCL Has-active-ingredient mappings. Combination drugs will carry multiple
+ingredient entries. Unmatched ingredients may use text only without a coded value.
+"""
+* ingredient.item[x] only CodeableConcept
+* ingredient.itemCodeableConcept 1..1 MS
+* ingredient.itemCodeableConcept from BDICD11SubstancesVS (extensible)
+* ingredient.itemCodeableConcept ^short = "ICD-11 substance code for the ingredient"
+* ingredient.itemCodeableConcept ^definition = """
+ICD-11 MMS substance code (XM-prefix) identifying the active ingredient.
+Source value set: https://fhir.dghs.gov.bd/core/ValueSet/icd11-substances-valueset
+served from the national OCL terminology server.
+For ingredients not yet mapped to ICD-11 substances, use text only.
+"""
+* ingredient.strength 0..1
+* ingredient.strength ^short = "Strength of the ingredient (optional)"
+* ingredient.strength ^definition = """
+Strength of the active ingredient. Optional in this profile as strength data
+is maintained in the DGDA registry and accessible via OCL. May be populated
+by dispensing systems for precision medication management.
+"""

input/fsh/profile/BDMedicationRequest.fsh

@@ -1,24 +1,66 @@
-// @Name: Profile
-// @Description: Example of a profile of the MedicationRequest resource. This example includes a few of the most commonly used constraints and documentation features of FHIR profiles.
-
 Profile: BDMedicationRequest
 Id: bd-medication-request
 Parent: MedicationRequest
-Title: "Medication Request Profile for Bangladesh-V2"
+Title: "Medication Request Profile for Bangladesh"
-Description: "Profile of MedicationRequest Bangladesh Standard V2"
+Description: """
+Profile of the MedicationRequest resource for the Bangladesh National Health
+Information Exchange (HIE). Prescriptions must reference a BDMedication
+resource coded against the DGDA Drug Registry, ensuring all prescribed
+medications are traceable to DGDA-registered drug products.
+
+This profile constrains medication references to BDMedication only.
+Inline medicationCodeableConcept is not permitted — all medication data
+must be carried in a referenced BDMedication resource to support ingredient
+coding for IPS and cross-border data exchange.
+
+Route of administration is coded using HL7 v3 RouteOfAdministration served
+via the national OCL terminology server.
+"""
+
+* identifier 1..* MS
+* identifier ^short = "Prescription identifier"
+* identifier ^definition = """
+Business identifier for this prescription. At least one identifier is required
+to support prescription tracking within the Bangladesh HIE.
+"""
 
-* identifier 1..*
 * medication[x] 1..1 MS
-* medication[x] only Reference(BDMedication) or CodeableConcept
+* medication[x] only Reference(BDMedication)
-* subject only Reference(BDPatientProfile)
+* medication[x] ^short = "Reference to DGDA-registered medication"
+* medication[x] ^definition = """
+Reference to a BDMedication resource identifying the prescribed drug product.
+The referenced BDMedication must carry a valid DGDA drug registry code.
+Inline CodeableConcept is not permitted in this profile.
+"""
+
+* subject 1..1 MS
+* subject only Reference(BDPatient)
+* subject ^short = "Patient for whom the medication is prescribed"
 
 * encounter 0..1 MS
-* encounter only Reference(BDEncounterProfile)
+* encounter only Reference(BDEncounter)
-* encounter ^definition = "The encounter during which this prescription was created."
+* encounter ^short = "Encounter during which this prescription was created"
-* authoredOn 1..1
+* encounter ^definition = """
-* requester 1..1
+The encounter during which this prescription was created. Should be populated
+for inpatient and outpatient prescriptions where an encounter record exists.
+"""
 
-* reportedReference only Reference(BDPractitioner or BDOrganization or BDPatientProfile)
+* authoredOn 1..1 MS
+* authoredOn ^short = "Date and time the prescription was authored"
+
+* requester 1..1 MS
 * requester only Reference(BDPractitioner or BDOrganization)
+* requester ^short = "Practitioner or organisation that authored the prescription"
+
+* reportedReference only Reference(BDPractitioner or BDOrganization or BDPatient)
+
 * priorPrescription only Reference(BDMedicationRequest)
-* basedOn only Reference(BDMedicationRequest or ServiceRequest or CarePlan or ImmunizationRecommendation)
+* priorPrescription ^short = "Reference to a prior prescription this replaces"
+
+* basedOn only Reference(BDMedicationRequest or ServiceRequest or CarePlan or ImmunizationRecommendation)
+* basedOn ^short = "Plan or request this prescription is based on"
+
+* dosageInstruction 0..* MS
+* dosageInstruction.route MS
+* dosageInstruction.route from BDRouteOfAdministrationVS (required)
+* dosageInstruction.route ^short = "Route of administration coded using HL7 v3 RouteOfAdministration"

input/fsh/profile/BDObservation.fsh

@@ -2,51 +2,83 @@ Profile:     BDObservationProfile
 Id:          bd-observation
 Parent:      Observation
 Title:       "Bangladesh Observation Profile"
-Description: "Bangladesh Observation Profile"
+Description: """
-* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-observation"
+Base observation profile for Bangladesh. This is an abstract-style base profile
-* ^version = "1.0.0"
+from which all BD-Core observation profiles are derived. It is not intended to
-* ^status = #active
+be used directly in clinical resources — use a derived profile instead.
 
-* identifier 1..* MS
+Derived profiles (v0.4.0):
+  - bd-lab-panel-observation  : Laboratory panel/order (hasMember pattern)
+  - bd-lab-result-observation : Laboratory leaf result (child of hasMember)
+
+Planned derived profiles (v0.5.0+):
+  - bd-vital-signs-observation
+  - bd-exam-observation
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-observation"
+* ^version = "2.0.0"
+* ^status = #draft
+
+// ── Identifier ────────────────────────────────────────────────────────────
+// 0..* at base — not all observation types carry identifiers.
+// Child profiles (e.g. lab results) constrain to 1..*.
+* identifier 0..* MS
 * identifier.value 1..1
 
+// ── Status ────────────────────────────────────────────────────────────────
 * status 1..1
 
-* partOf 0..*
+// ── Category ──────────────────────────────────────────────────────────────
-
+// Preferred binding at base — child profiles fix to specific category codes
+// (e.g. laboratory, vital-signs). Required binding here would block child
+// profiles from narrowing to a fixed category slice.
 * category 1..* MS
-* category from http://hl7.org/fhir/ValueSet/observation-category (required)
+* category from http://hl7.org/fhir/ValueSet/observation-category (preferred)
-* category ^definition = "Type of category"
+* category ^definition = "Type of observation category"
-* category ^comment = "E.g. vital, physical examination"
+* category ^comment = "E.g. laboratory, vital-signs, exam. Child profiles fix this to a specific value."
 
+// ── Code ──────────────────────────────────────────────────────────────────
+// Extensible binding at base — child profiles bind to narrower ValueSets
+// (e.g. BD LOINC lab panels, BD LOINC lab results). Required binding here
+// would prevent child profiles from using a subset binding.
 * code 1..1 MS
-* code from http://hl7.org/fhir/ValueSet/observation-codes (required)
+* code from http://hl7.org/fhir/ValueSet/observation-codes (example)
-* code ^definition = "Type of test/measurement"
+* code ^definition = "Type of observation / test / measurement"
-* code ^comment = "E.g., Hb, RBS, CBC"
+* code ^comment = "E.g. Hb, RBS, CBC. Child profiles bind to specific ValueSets."
 
-// Subject: Reference to Patient Profile (Required)
+// ── Subject ───────────────────────────────────────────────────────────────
 * subject 1..1 MS
+* subject only Reference(Patient)
 * subject.reference 1..1 MS
 * subject.display 1..1 MS
 * subject.identifier 0..1
-* subject ^definition = "Reference to Patient Profile"
+* subject ^definition = "Reference to the Patient this observation is about"
 * subject ^comment = "EX: http://mci.mcishr.dghs.gov.bd/api/v1/patients/98002412586"
 
-
+// ── Encounter ─────────────────────────────────────────────────────────────
 * encounter 1..1 MS
 * encounter.reference 1..1 MS
-* encounter ^definition = "Reference to Patient Profile"
+* encounter ^definition = "Reference to the Encounter during which this observation was made"
-* encounter ^comment = "EX: uuid:34c38499-58ab-41e0-8e94-c3931491ad0e - bundle encounter uuid from local"
+* encounter ^comment = "EX: uuid:34c38499-58ab-41e0-8e94-c3931491ad0e"
 
+// ── Performer ─────────────────────────────────────────────────────────────
 * performer 1..*
 * performer.reference 1..1
 
-// Value[x]: Result value (Optional, but constrained)
+// ── Part Of ───────────────────────────────────────────────────────────────
+* partOf 0..*
+
+// ── Value[x] ──────────────────────────────────────────────────────────────
+// 0..1 at base — child profiles constrain presence and type.
+// Panel observations set value[x] to 0..0.
+// Result observations set value[x] to 1..1.
 * value[x] 0..1
 * value[x] ^definition = "Result value (Quantity, string, code, boolean, etc.)"
 * valueQuantity 0..1
 * valueQuantity ^comment = "If numeric, must include UCUM unit"
 * valueQuantity.system 0..1
+* valueQuantity.system = "http://unitsofmeasure.org"
 * valueQuantity.code 0..1
 * valueString 0..1
 * valueCodeableConcept 0..1
@@ -59,26 +91,43 @@ Description: "Bangladesh Observation Profile"
 * valueDateTime 0..1
 * valuePeriod 0..1
 
+// ── Interpretation ────────────────────────────────────────────────────────
+// Extensible at base — required was too strict for general observation use.
 * interpretation 0..*
-* interpretation from http://hl7.org/fhir/ValueSet/observation-interpretation (required)
+* interpretation from http://hl7.org/fhir/ValueSet/observation-interpretation (extensible)
-* interpretation ^definition = "Type of test/measurement"
+* interpretation ^definition = "Assessment of the observation result"
-* interpretation ^comment = "E.g.: High, low, normal, etc"
+* interpretation ^comment = "E.g. High, Low, Normal"
 
+// ── Method ────────────────────────────────────────────────────────────────
+// Extensible at base — required was too strict for general observation use.
 * method 0..1
-* method from http://hl7.org/fhir/ValueSet/observation-methods (required)
+* method from http://hl7.org/fhir/ValueSet/observation-methods (extensible)
 * method ^definition = "Type of observation method"
-* method ^comment = "E.g.: Technique, Total measurement"
+* method ^comment = "E.g. Technique, Total measurement"
 
-// Issued: Date/time result was issued (Optional)
+// ── Issued ────────────────────────────────────────────────────────────────
 * issued 0..1
-* issued ^definition = "Date/time result was issued"
+* issued ^definition = "Date/time the result was issued"
 
-// Reference Range: Normal reference range (Optional)
+// ── Reference Range ───────────────────────────────────────────────────────
 * referenceRange 0..*
-* referenceRange ^definition = "Normal reference range"
+* referenceRange ^definition = "Normal reference range for the observation"
-* referenceRange ^comment = "Optional"
 
-// Specimen: Specimen used for the observation (Optional)
+// ── Specimen ──────────────────────────────────────────────────────────────
-* specimen 0..1
+// MustSupport at base — relevant for lab, pathology, and future imaging.
-* specimen ^definition = "Specimen used for the observation"
+* specimen 0..1 MS
-* specimen ^comment = "Optional"
+* specimen ^definition = "Specimen used for this observation"
+
+// ── hasMember ─────────────────────────────────────────────────────────────
+// Defined at base to support the panel/component pattern.
+// bd-lab-panel-observation constrains this to 1..* typed references.
+// bd-lab-result-observation constrains this to 0..0.
+* hasMember 0..* MS
+* hasMember ^definition = "References to component result Observations that belong to this panel"
+* hasMember ^comment = "Used in panel-type Observations. Leaf result Observations must not use hasMember."
+
+// ── derivedFrom ───────────────────────────────────────────────────────────
+// Defined at base to support child results referencing their parent panel.
+* derivedFrom 0..* MS
+* derivedFrom ^definition = "References to the panel Observation from which this result is derived"
+* derivedFrom ^comment = "Used in leaf result Observations to reference their parent panel."

input/fsh/profile/BDPatient.fsh

@@ -1,7 +1,7 @@
 Alias: $translation = http://hl7.org/fhir/StructureDefinition/translation
 // @Name: Profile
 // @Description: Example of a profile of the Patient resource. This example includes a few of the most commonly used constraints and documentation features of FHIR profiles.
-Profile:     BDPatientProfile
+Profile:     BDPatient
 Id:          bd-patient
 Parent:      Patient
 Title:       "Patient Profile for Bangladesh"
@@ -13,27 +13,13 @@ Patient profile for Bangladesh.
 """
 
 // ----- Begin rules:
-// Require exactly one HumanName
 * name 1..1 MS
 * name.use 1..1
 * name.use = #official (exactly)
-
-// Require a text element
 * name.text 1..1 MS
-
-// Require translation extensions on text
-* name.text.extension 2..* MS
 * name.text.extension contains
-    $translation named nameEn 1..1 MS and
+    BDNameEn named nameEn 1..1 MS and
-    $translation named nameBn 1..1 MS
+    BDNameBn named nameBn 0..1 MS
-
-// Constraints on English name
-* name.text.extension[nameEn].extension[lang].valueCode = #en (exactly)
-* name.text.extension[nameEn].extension[content] 1..1 MS
-
-// Constraints on Bangla name
-* name.text.extension[nameBn].extension[lang].valueCode = #bn (exactly)
-* name.text.extension[nameBn].extension[content] 1..1 MS
 
 //////////////////////
 
@@ -46,12 +32,12 @@ Patient profile for Bangladesh.
 * identifier contains
     NID 0..1 and
     BRN 0..1 and
-    UHID 0..1
+    UHID 1..1
 
 * identifier[NID].system = "http://dghs.gov.bd/identifier/nid"
 * identifier[NID].type.coding.code = #NID
 // * identifier[NID].type.coding.system = "http://terminology.hl7.org/CodeSystem/v2-0203"
-* identifier[NID].type.coding.system = "https://fhir.dghs.gov.bd/core/ValueSet/bd-identifier-type-valueset"
+* identifier[NID].type.coding.system = "https://fhir.dghs.gov.bd/core/CodeSystem/bd-identifier-type"
 * identifier[NID].type from BangladeshIdentifierTypeVS (extensible)
 * identifier[NID].type.text = "Organization identifier"
 // * identifier[NID].value = "Personal identifier National ID"
@@ -61,7 +47,7 @@ Patient profile for Bangladesh.
 
 * identifier[BRN].system = "http://dghs.gov.bd/identifier/brn"
 * identifier[BRN].type.coding.code = #BRN
-* identifier[BRN].type.coding.system = "https://fhir.dghs.gov.bd/core/ValueSet/bd-identifier-type-valueset"
+* identifier[BRN].type.coding.system = "https://fhir.dghs.gov.bd/core/CodeSystem/bd-identifier-type"
 * identifier[BRN].type from BangladeshIdentifierTypeVS (extensible)
 * identifier[BRN].type.text = "Organization identifier"
 // * identifier[BRN].value = "Personal identifier Birth Registration"
@@ -69,7 +55,7 @@ Patient profile for Bangladesh.
 
 * identifier[UHID].system = "http://dghs.gov.bd/identifier/uhid"
 * identifier[UHID].type.coding.code = #UHID
-* identifier[UHID].type.coding.system = "https://fhir.dghs.gov.bd/core/ValueSet/bd-identifier-type-valueset"
+* identifier[UHID].type.coding.system = "https://fhir.dghs.gov.bd/core/CodeSystem/bd-identifier-type"
 * identifier[UHID].type from BangladeshIdentifierTypeVS (extensible)
 * identifier[UHID].type.text = "Organization identifier"
 
@@ -89,7 +75,9 @@ Patient profile for Bangladesh.
 
 
 // Require a value from a specific value set be used for an element
-* maritalStatus from http://hl7.org/fhir/ValueSet/marital-status
+// * maritalStatus from http://hl7.org/fhir/ValueSet/marital-status
+* maritalStatus 0..1 MS
+* maritalStatus from BDMaritalStatusVS
 
 // Restrict something[x] to a specific type -- in this case only allowing dateTime to be used
 * deceased[x] only dateTime
@@ -100,3 +88,19 @@ Patient profile for Bangladesh.
 
 * address 1..* MS
 * address only BDAddress
+
+// ── Photo ─────────────────────────────────────────────────────────────────
+// Optional patient photo — may be used for identity verification at point of care.
+* photo 0..* MS
+* photo ^definition = "Patient photo for identity verification"
+* photo ^comment = "Attach a photo of the patient when available. Use image/jpeg or image/png."
+
+// ── Link to RelatedPerson ─────────────────────────────────────────────────
+// At least one RelatedPerson link is required — father, mother, or guardian.
+// The referenced RelatedPerson must carry a BD identifier and a relationship.
+* link 0..* MS
+* link ^definition = "Link to a RelatedPerson resource representing father, mother, or guardian"
+* link ^comment = "At least one RelatedPerson with BD identifier and relationship is required."
+* link.other 1..1 MS
+* link.other only Reference(BDRelatedPerson)
+* link.type = #seealso (exactly)

input/fsh/profile/BDRelatedPerson.fsh

@@ -0,0 +1,55 @@
+Profile: BDRelatedPerson
+Id: bd-related-person
+Parent: RelatedPerson
+Title: "Related Person Profile for Bangladesh"
+Description: """
+Profile for RelatedPerson in Bangladesh.
+Used to represent father, mother, or guardian of a patient.
+- Identifier is mandatory and must use BD identifier systems (NID, BRN, UHID)
+- Relationship is mandatory
+- Name is mandatory
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/StructureDefinition/bd-related-person"
+
+// ── Identifier ────────────────────────────────────────────────────────────
+// Mandatory BD identifier — NID, BRN, or UHID
+* identifier 1..* MS
+* identifier ^slicing.discriminator.type = #value
+* identifier ^slicing.discriminator.path = "system"
+* identifier ^slicing.rules = #open
+* identifier ^slicing.ordered = false
+* identifier contains
+    NID 0..1 and
+    BRN 0..1 and
+    UHID 0..1
+
+* identifier[NID].system = "http://dghs.gov.bd/identifier/nid"
+* identifier[NID].type.coding.code = #NID
+* identifier[NID].type.coding.system = "https://fhir.dghs.gov.bd/core/CodeSystem/bd-identifier-type"
+* identifier[NID].type.text = "Organization identifier"
+
+* identifier[BRN].system = "http://dghs.gov.bd/identifier/brn"
+* identifier[BRN].type.coding.code = #BRN
+* identifier[BRN].type.coding.system = "https://fhir.dghs.gov.bd/core/CodeSystem/bd-identifier-type"
+* identifier[BRN].type.text = "Organization identifier"
+
+* identifier[UHID].system = "http://dghs.gov.bd/identifier/uhid"
+* identifier[UHID].type.coding.code = #UHID
+* identifier[UHID].type.coding.system = "https://fhir.dghs.gov.bd/core/CodeSystem/bd-identifier-type"
+* identifier[UHID].type.text = "Organization identifier"
+
+// ── Relationship ──────────────────────────────────────────────────────────
+// Mandatory — must specify the relationship to the patient
+* relationship 1..* MS
+* relationship ^definition = "Relationship of this person to the patient"
+* relationship ^comment = "E.g. FTH (father), MTH (mother), GUARD (guardian) from v3-RoleCode"
+
+// ── Name ──────────────────────────────────────────────────────────────────
+* name 1..1 MS
+* name ^definition = "Name of the related person"
+
+// ── Patient ───────────────────────────────────────────────────────────────
+* patient 1..1 MS
+* patient only Reference(BDPatient)
+* patient ^definition = "The patient this related person is associated with"

input/fsh/profile/bdAddress.fsh

@@ -10,8 +10,10 @@ Description: "Address for Bangladesh Standard"
 
 * country 1..1 MS
 * extension contains Division named division 1..1 MS
+* extension[division] ^short = "Division code"
 
 * district 1..1 MS
 * district from BDDistrictsVS
 
-* extension contains Upazillas named upazilla 1..1 MS
+* extension contains Upazillas named upazilla 1..1 MS
+* extension[upazilla] ^short = "Upazilla code"

input/fsh/valueSets/BDConditionICD11DiagnosisVS.fsh

@@ -0,0 +1,62 @@
+// ============================================================
+// BDConditionICD11DiagnosisVS.fsh
+// ICD-11 MMS ValueSet restricted to Diagnosis and Finding classes
+// Binding target for Condition.code in BDConditionProfile
+// Empty stub — runtime enforcement via OCL $validate-code
+// $expand not available — suppressed in sushi-config.yaml
+// ============================================================
+
+ValueSet: BDConditionICD11DiagnosisVS
+Id: bd-condition-icd11-diagnosis-valueset
+Title: "Bangladesh ICD-11 MMS Condition ValueSet (Diagnosis and Finding)"
+Description: """
+ICD-11 MMS concepts restricted to the Diagnosis (14,071) and Finding (5,590)
+concept classes, totalling 19,661 concepts as of version 2025-01.
+
+This ValueSet is the binding target for Condition.code in the BD-Core
+Condition profile. Substance, Organism, Device, Anatomy, and Misc class
+concepts are excluded and SHALL NOT appear as standalone stem codes in
+Condition.code. This restriction applies to stem codes only — satellite
+codes carried in the icd11-cluster-expression extension are exempt.
+
+This ValueSet is an empty stub. No compose block is declared because
+$expand is not supported by the national OCL terminology server and
+no machine-executable filter for concept_class is available at the
+IG layer. The compose would be nominal only and is omitted to avoid
+misrepresenting machine-executable semantics.
+
+The ValueSet is hosted in OCL as a collection with 19,661 explicit
+concept references (Diagnosis and Finding classes only). Runtime
+enforcement is via OCL ValueSet $validate-code:
+
+  GET https://tr.ocl.dghs.gov.bd/api/fhir/ValueSet/$validate-code
+      ?url=https://fhir.dghs.gov.bd/core/ValueSet/bd-condition-icd11-diagnosis-valueset
+      &system=http://id.who.int/icd/release/11/mms
+      &code={code}
+
+Confirmed behaviour:
+  - Diagnosis class (e.g. 1A00): accepted
+  - Finding class: accepted
+  - Device class (e.g. XD7EB1): rejected
+  - Substance class (e.g. XM6RB2): rejected
+
+At the HAPI FHIR layer, enforcement is via RemoteTerminologyServiceValidationSupport
+configured to call OCL. HAPI FHIR deployment is a known gap to be closed
+before vendor onboarding.
+
+VERSION UPGRADES:
+  Upgrading to a new ICD-11 MMS release requires re-running
+  populate_condition_valueset.py. Automated via version_upgrade.py.
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/bd-condition-icd11-diagnosis-valueset"
+* ^status = #active
+* ^experimental = false
+* ^version = "2025-01"
+* ^publisher = "Directorate General of Health Services (DGHS), MoHFW, Bangladesh"
+* ^contact.name = "DGHS Health Informatics Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^copyright = "ICD-11 is copyright © World Health Organization. Used under licence."
+* ^immutable = false

input/fsh/valueSets/BDConditionICD11VS.fsh

@@ -1,6 +0,0 @@
-ValueSet: BDConditionICD11VS
-Id: bd-condition-icd11-valueset
-Title: "Bangladesh ICD-11 MMS ValueSet"
-Description: "ValueSet that includes the ICD-11 MMS CodeSystem for Condition.code"
-* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/bd-condition-icd11-valueset"
-* include codes from system http://id.who.int/icd/release/11/mms

input/fsh/valueSets/BDDGDADrugsVS.fsh

@@ -0,0 +1,34 @@
+ValueSet: BDDGDADrugsVS
+Id: dgda-registered-drugs
+Title: "DGDA Registered Drugs Value Set"
+Description: """
+Value set containing all registered drug products from the Drug Registration
+Authority (DGDA) of Bangladesh. This value set includes 39,196 finished
+pharmaceutical drug product concepts maintained in the national OCL terminology
+server at https://tr.ocl.dghs.gov.bd.
+
+This value set is the normative binding for BDMedication.code and represents
+the only permitted drug coding vocabulary for medication resources in the
+Bangladesh national health information exchange.
+
+Validation is performed via $validate-code and $lookup against the national
+OCL terminology server. $expand is not supported for this value set due to its
+size.
+
+Source collection: dgda-registered-drugs-valueset (MoHFW organisation, OCL)
+OCL collection canonical: https://dgda.gov.bd/fhir/ValueSet/registered-drugs
+OCL FHIR endpoint: https://tr.ocl.dghs.gov.bd/orgs/MoHFW/collections/dgda-registered-drugs-valueset/
+"""
+
+* ^url = "https://dgda.gov.bd/fhir/ValueSet/registered-drugs"
+* ^version = "v1.0.0"
+* ^status = #active
+* ^experimental = false
+* ^publisher = "Directorate General of Drug Administration (DGDA), Government of Bangladesh"
+* ^contact.name = "DGHS Health Informatics Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^immutable = false
+
+* include codes from system https://dgda.gov.bd/drug-registry

input/fsh/valueSets/BDICD11SubstancesVS.fsh

@@ -0,0 +1,32 @@
+ValueSet: BDICD11SubstancesVS
+Id: icd11-substances-valueset
+Title: "ICD-11 Substances Value Set"
+Description: """
+Value set containing all ICD-11 MMS substance and medicament concepts
+(XM-prefix concept class: Substance) maintained in the national OCL
+terminology server at https://tr.ocl.dghs.gov.bd.
+
+This value set contains 7,776 substance concepts and is used for coding
+active pharmaceutical ingredients in the BDMedication.ingredient element
+to support IPS generation and cross-border data exchange.
+
+This value set is defined and maintained in OCL. It is declared here as a
+minimal stub to allow IG publisher binding resolution only.
+
+**OCL collection canonical:** https://fhir.dghs.gov.bd/core/ValueSet/icd11-substances-valueset
+**OCL FHIR endpoint:** https://tr.ocl.dghs.gov.bd/orgs/MoHFW/collections/icd11-substances-valueset/
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/icd11-substances-valueset"
+* ^version = "2025-01"
+* ^status = #active
+* ^experimental = false
+* ^publisher = "World Health Organization (WHO) — served via DGHS National OCL"
+* ^contact.name = "DGHS Health Informatics Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^immutable = false
+
+* include codes from system http://id.who.int/icd/release/11/mms
+    where concept-class = "Substance"

input/fsh/valueSets/BDLoincAnswerListsVS.fsh

@@ -0,0 +1,22 @@
+ValueSet:    BDLoincAnswerListsVS
+Id:          bd-loinc-answer-lists-valueset
+Title:       "Bangladesh LOINC Answer Lists ValueSet"
+Description: "LOINC answer codes (LA-prefixed) and answer list groupers (LL-prefixed) 
+for Bangladesh laboratory results. Includes all answer codes referenced by in-scope 
+lab result codes from LOINC 2.82. Used as Observation.valueCodeableConcept in 
+bd-lab-result-observation for ordinal and nominal scale results."
+
+* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/bd-loinc-answer-lists-valueset"
+* ^status = #draft
+* ^experimental = true
+* ^version = "0.1.0"
+* ^publisher = "Directorate General of Health Services (DGHS), MoHFW, Bangladesh"
+* ^contact.name = "DGHS Health Information Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^copyright = "This content from LOINC® is copyright © 1995 Regenstrief Institute, Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-of-use."
+* ^immutable = false
+
+* include codes from system http://loinc.org
+    where concept in "https://fhir.dghs.gov.bd/core/ValueSet/loinc-answer-lists"

input/fsh/valueSets/BDLoincLabPanelsVS.fsh

@@ -0,0 +1,21 @@
+ValueSet:    BDLoincLabPanelsVS
+Id:          bd-loinc-lab-panels-valueset
+Title:       "Bangladesh LOINC Lab Panels ValueSet"
+Description: "LOINC orderable laboratory panel codes for Bangladesh. Includes universal 
+lab order panel codes from LOINC 2.82 scoped to the Universal Lab Orders ValueSet. 
+Used as Observation.code in bd-lab-panel-observation."
+
+* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/bd-loinc-lab-panels-valueset"
+* ^status = #draft
+* ^experimental = true
+* ^version = "0.1.0"
+* ^publisher = "Directorate General of Health Services (DGHS), MoHFW, Bangladesh"
+* ^contact.name = "DGHS Health Information Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^copyright = "This content from LOINC® is copyright © 1995 Regenstrief Institute, Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-of-use."
+* ^immutable = false
+
+* include codes from system http://loinc.org
+    where concept in "https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-panels"

input/fsh/valueSets/BDLoincLabResultsVS.fsh

@@ -0,0 +1,22 @@
+ValueSet:    BDLoincLabResultsVS
+Id:          bd-loinc-lab-results-valueset
+Title:       "Bangladesh LOINC Lab Results ValueSet"
+Description: "LOINC leaf-level laboratory result codes for Bangladesh. Includes 
+individual component/result codes from LOINC 2.82 scoped to the Universal Lab Orders 
+ValueSet. Excludes discouraged and non-laboratory codes. Used as Observation.code 
+in bd-lab-result-observation."
+
+* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/bd-loinc-lab-results-valueset"
+* ^status = #draft
+* ^experimental = true
+* ^version = "0.1.0"
+* ^publisher = "Directorate General of Health Services (DGHS), MoHFW, Bangladesh"
+* ^contact.name = "DGHS Health Information Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^copyright = "This content from LOINC® is copyright © 1995 Regenstrief Institute, Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-of-use."
+* ^immutable = false
+
+* include codes from system http://loinc.org
+    where concept in "https://fhir.dghs.gov.bd/core/ValueSet/loinc-lab-results"

input/fsh/valueSets/BDMedicationDoseFormVS.fsh

@@ -0,0 +1,36 @@
+ValueSet: BDMedicationDoseFormVS
+Id: bd-medication-dose-form
+Title: "Medication Dose Form Value Set"
+Description: """
+Value set containing pharmaceutical dose form concepts from the European
+Directorate for the Quality of Medicines (EDQM) Standard Terms, domain:
+Pharmaceutical Dose Forms (PDF).
+
+This value set is used to code the physical form of a medication product
+in BDMedication.form. EDQM Standard Terms are maintained and versioned
+by the Council of Europe and are the WHO-recommended international standard
+for pharmaceutical dose form coding.
+
+Concepts are loaded into the national OCL terminology server at
+https://tr.ocl.dghs.gov.bd under the MoHFW organisation as source EDQM-PDF.
+
+**Binding:** preferred on BDMedication.form — systems should use EDQM
+codes when populating dose form, but omission is permitted. A mapping from
+DGDA plain text dose forms to EDQM codes is planned for a future IG version.
+
+**Code system canonical:** https://standardterms.edqm.eu
+**OCL source:** https://tr.ocl.dghs.gov.bd/#/orgs/MoHFW/sources/EDQM-PDF/
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/edqm-dose-forms"
+* ^version = "1.0.0"
+* ^status = #active
+* ^experimental = false
+* ^publisher = "DGHS Health Informatics Unit"
+* ^contact.name = "DGHS Health Informatics Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^immutable = false
+
+* include codes from system https://standardterms.edqm.eu

input/fsh/valueSets/BDRouteOfAdministrationVS.fsh

@@ -0,0 +1,31 @@
+ValueSet: BDRouteOfAdministrationVS
+Id: bd-route-of-administration
+Title: "Route of Administration Value Set"
+Description: """
+Value set containing route of administration concepts from the HL7 Version 3
+RouteOfAdministration code system.
+
+This value set is used to code the route by which a medication is administered
+in MedicationRequest.dosageInstruction.route. HL7 v3 RouteOfAdministration
+is a license-free, internationally recognised vocabulary already embedded in
+the FHIR ecosystem.
+
+Concepts are loaded into the national OCL terminology server at
+https://tr.ocl.dghs.gov.bd under the MoHFW organisation.
+
+**Code system canonical:** http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration
+**Binding:** required on BDMedicationRequest.dosageInstruction.route
+"""
+
+* ^url = "https://fhir.dghs.gov.bd/core/ValueSet/bd-route-of-administration"
+* ^version = "1.0.0"
+* ^status = #active
+* ^experimental = false
+* ^publisher = "DGHS Health Informatics Unit"
+* ^contact.name = "DGHS Health Informatics Unit"
+* ^contact.telecom.system = #url
+* ^contact.telecom.value = "https://dghs.gov.bd"
+* ^jurisdiction = urn:iso:std:iso:3166#BD "Bangladesh"
+* ^immutable = false
+
+* include codes from system http://terminology.hl7.org/CodeSystem/v3-RouteOfAdministration

input/package-list.json

@@ -11,10 +11,82 @@
       "status": "ci-build",
       "current": true
     },
+    {
+      "version": "0.4.5",
+      "date": "2026-04-10",
+      "desc": "minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.5/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.4",
+      "date": "2026-04-06",
+      "desc": "minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.4/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.3",
+      "date": "2026-04-06",
+      "desc": "minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.3/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.2",
+      "date": "2026-04-06",
+      "desc": "Patient profile minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.2/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.1",
+      "date": "2026-04-06",
+      "desc": "DGDA Drug and LOINC Integration with minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.1/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.0",
+      "date": "2026-04-06",
+      "desc": "DGDA Drug and LOINC Integration",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.0/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.3.0",
+      "date": "2026-03-08",
+      "desc": "ICD-11 MMS integration and minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.3.0/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.2.5",
+      "date": "2025-10-06",
+      "desc": "Minor bug fix release",
+      "path": "https://fhir.dghs.gov.bd/core/0.2.5/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.2.4",
+      "date": "2025-10-06",
+      "desc": "Minor visual improvements",
+      "path": "https://fhir.dghs.gov.bd/core/0.2.4/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
     {
       "version": "0.2.3",
       "date": "2025-10-06",
-      "desc": "Second draft release of the Bangladesh Core FHIR IG",
+      "desc": "Minor documentation updates",
       "path": "https://fhir.dghs.gov.bd/core/0.2.3/",
       "status": "trial-use",
       "sequence": "STU 1"
@@ -22,7 +94,7 @@
     {
       "version": "0.2.2",
       "date": "2025-10-06",
-      "desc": "Second draft release of the Bangladesh Core FHIR IG",
+      "desc": "Minor bug fix release",
       "path": "https://fhir.dghs.gov.bd/core/0.2.2/",
       "status": "trial-use",
       "sequence": "STU 1"

input/pagecontent/index.xml

@@ -8,6 +8,33 @@
   <p>
     By adopting international FHIR standards, this guide helps ensure that patient data can flow smoothly between hospitals, clinics, and national programs, while also enabling future cross-border health information exchange.
   </p>
+  <hr/>
+
+  <h4>FHIR Sandbox Server</h4>
+
+  <p>
+    A live sandbox environment is available for testing and development based on this implementation guide.
+  </p>
+
+  <p>
+    <b>Base URL:</b><br/>
+    <a href="https://sandbox.fhir.dghs.gov.bd/fhir" target="_blank">
+      https://sandbox.fhir.dghs.gov.bd/fhir
+    </a>
+  </p>
+
+  <p>
+    This sandbox supports HL7 FHIR R4 and implements the Bangladesh Core FHIR profiles and terminology bindings.
+    It is intended for testing, validation, and system integration only.
+  </p>
+  <ul>
+    <li><a href="https://sandbox.fhir.dghs.gov.bd/fhir/metadata" target="_blank" rel="noopener noreferrer">Capability Statement</a></li>
+    <li><a href="https://sandbox.fhir.dghs.gov.bd" target="_blank" rel="noopener noreferrer">FHIR Tester UI</a></li>
+  </ul>
+  <p>
+    Developers are encouraged to validate their implementations against this sandbox before moving to production environments.
+  </p>
+  <hr/>
 	<a name="technical"> </a>
 	<h3>Technical Overview</h3>
 	<p>

input/pagecontent/spec.md

@@ -1,5 +1,135 @@
-### A Heading
+## Bangladesh Core FHIR Implementation Guide — General Specification
-You can also use markdown if that's your thing
 
-And an icon: ![resource](icon-resource.png)
+### Purpose and Scope
 
+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:
+- **Bangladesh Digital Health Strategy 2023–2027**
+- **Bangladesh Digital Health Architecture Blueprint**
+
+The Patient profile strictly conforms to the **Citizen Core Data Structure
+(CCDS)** defined by the Cabinet Division of the Government of Bangladesh.
+
+---
+
+### Intended Audience
+
+This IG is addressed to all software systems exchanging health data with
+the national SHR, including but not limited to:
+
+- Electronic Medical Record (EMR) systems
+- Laboratory Information Systems (LIS)
+- Picture Archiving and Communication Systems (PACS)
+- Hospital Information Systems (HIS)
+
+This includes systems operated by public sector facilities, private
+hospitals and clinics, autonomous bodies, and non-governmental
+organisations (NGOs) operating within Bangladesh.
+
+---
+
+### FHIR Version and Conventions
+
+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.
+
+---
+
+### Design Principles
+
+**1. National terminology over international defaults**
+Where international code systems are used (ICD-11, LOINC, SNOMED CT),
+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 are \[TODO: to be defined in a future revision\].
+
+---
+
+### Profiles
+
+The following national core profiles are defined in this IG:
+
+| Profile | Base Resource | Purpose |
+|---|---|---|
+| [BD Patient](StructureDefinition-bd-patient.html) | Patient | Citizen identity conforming to CCDS |
+| [BD Condition](StructureDefinition-bd-condition.html) | Condition | Clinical conditions coded with ICD-11 MMS |
+| [BD Observation](StructureDefinition-bd-observation.html) | Observation | Vital signs, laboratory results, clinical findings |
+| [BD Encounter](StructureDefinition-bd-encounter.html) | Encounter | Clinical visits and episodes of care |
+| [BD Medication](StructureDefinition-bd-medication.html) | Medication | Medication definitions |
+| [BD MedicationRequest](StructureDefinition-bd-medicationrequest.html) | MedicationRequest | Prescriptions and medication orders |
+| [BD Immunization](StructureDefinition-bd-immunization.html) | Immunization | Vaccination records |
+| [BD Organization](StructureDefinition-bd-organization.html) | Organization | Health facilities and organisations |
+| [BD Practitioner](StructureDefinition-bd-practitioner.html) | Practitioner | Healthcare providers |
+| [BD Location](StructureDefinition-bd-location.html) | Location | Physical locations and administrative geography |
+
+---
+
+### Terminology
+
+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` | Observation coding |
+| UCUM | `http://unitsofmeasure.org` | Observation units |
+| SNOMED CT | `http://snomed.info/sct` | Clinical terminology |
+
+Runtime terminology resolution is provided by the national OCL terminology
+server. See the [ICD-11 Implementation](icd11.html) page for full details
+of ICD-11 integration, postcoordination conventions, and conformance
+requirements.
+
+---
+
+### Known Gaps and Planned Work
+
+This IG is currently at version 0.2.5 with status `draft`. The following
+are known gaps to be addressed in future revisions:
+
+- **Must Support semantics** — sender and receiver obligations not yet
+  formally defined
+- **Capability Statements** — no CapabilityStatement resources defined yet
+- **Search Parameters** — no defined search parameter requirements yet
+- **Transaction Patterns** — no defined FHIR transaction or message patterns yet
+- **HAPI FHIR deployment** — `RemoteTerminologyServiceValidationSupport`
+  configuration for OCL not yet deployed; this is a prerequisite for
+  runtime ICD-11 class restriction enforcement before vendor onboarding
+- **Must Support definitions per profile** — individual profile pages do
+  not yet carry explicit MS obligation tables

input/pagecontent/spec2.md

@@ -1,2 +1,244 @@
-### A Heading
+## ICD-11 Implementation
-A child specification page with more detail
+
+### Overview
+
+The Bangladesh Core FHIR Implementation Guide uses ICD-11 Mortality and
+Morbidity Statistics (MMS) as the mandatory coding system for clinical
+conditions. This page documents the system URI, terminology infrastructure,
+conformance requirements, and postcoordination conventions for implementers.
+
+---
+
+### System URI
+
+All ICD-11 MMS codes SHALL use the WHO canonical system URI:
+```
+http://id.who.int/icd/release/11/mms
+```
+
+The preferred code form is the short stem code (e.g. `1A00`, `NC72.Z`).
+Linearization URIs are not used as code identifiers in this IG.
+
+---
+
+### Terminology Infrastructure
+
+#### National OCL Terminology Server
+
+Runtime code validation and lookup are delegated to the national
+OpenConceptLab (OCL) terminology server operated by DGHS/MoHFW:
+
+**Public FHIR R4 endpoint:** `https://tr.ocl.dghs.gov.bd`
+
+OCL hosts ICD-11 MMS version 2025-01 with 36,941 concepts across the
+following concept classes: Diagnosis, Finding, Substance, Organism,
+Device, Anatomy, and Misc.
+
+Vendors do not interact with OCL directly. All vendor submissions are
+validated at the HIE boundary via the Bangladesh ICD-11 Cluster Validator
+(see [Cluster Expressions](#cluster-expressions) below).
+
+#### Supported OCL Operations
+
+The following FHIR terminology operations are supported. The `system=`
+parameter must be used — `url=` is not supported by OCL.
+
+**CodeSystem $validate-code**
+```
+GET https://tr.ocl.dghs.gov.bd/api/fhir/CodeSystem/$validate-code
+    ?system=http://id.who.int/icd/release/11/mms&code={code}
+```
+
+**CodeSystem $lookup**
+```
+GET https://tr.ocl.dghs.gov.bd/api/fhir/CodeSystem/$lookup
+    ?system=http://id.who.int/icd/release/11/mms&code={code}
+```
+
+**ValueSet $validate-code**
+```
+GET https://tr.ocl.dghs.gov.bd/api/fhir/ValueSet/$validate-code
+    ?url=https://fhir.dghs.gov.bd/core/ValueSet/bd-condition-icd11-diagnosis-valueset
+    &system=http://id.who.int/icd/release/11/mms&code={code}
+```
+
+#### Unsupported OCL Operations
+
+`$expand` is not supported — this is a known limitation of the national
+OCL instance. Build-time expansion is suppressed. Implementers SHALL NOT
+depend on `$expand` for ICD-11 ValueSets in this IG.
+
+#### Local ICD-11 Docker Instance
+
+A local WHO ICD-11 Docker instance is maintained internally by DGHS at
+`https://icd11.dghs.gov.bd` running release 2025-01. This instance is
+internal only and is not exposed to vendors. It serves as the import
+source for OCL and as the backend for the cluster validator.
+
+---
+
+### Condition.code Binding and Class Restriction
+
+`Condition.code` is bound to the
+[Bangladesh ICD-11 MMS Condition ValueSet](ValueSet-bd-condition-icd11-diagnosis-valueset.html)
+at `preferred` strength. This ValueSet includes only Diagnosis (14,071)
+and Finding (5,590) class concepts — 19,661 concepts total as of
+version 2025-01.
+
+`Condition.code` SHALL contain at least one coding conforming to the
+`coding[stem]` slice with `system = http://id.who.int/icd/release/11/mms`.
+Vendors cannot omit ICD-11 by substituting a local code.
+
+The following concept classes SHALL NOT appear as standalone stem codes
+in `Condition.code`: Substance, Organism, Device, Anatomy, Misc.
+
+This restriction exists because these classes represent entities that
+are not themselves diagnoses or clinical findings — they are axes used
+in postcoordination (e.g. a causative substance, an affected anatomy
+site). Their correct use is as satellite codes within a cluster
+expression, not as standalone condition codes.
+
+Class restriction is enforced at runtime via OCL ValueSet `$validate-code`
+against the Bangladesh ICD-11 MMS Condition ValueSet. At the HAPI FHIR
+layer, enforcement is via `RemoteTerminologyServiceValidationSupport`
+configured to call OCL. HAPI FHIR deployment will be completed before
+vendor onboarding.
+
+The `coding[stem]` slice is open (`#open`) — additional local codings
+are permitted alongside the mandatory ICD-11 stem.
+
+---
+
+### Cluster Expressions
+
+#### Background
+
+ICD-11 supports postcoordination — the combination of a stem code with
+one or more satellite codes to precisely represent a clinical concept
+that cannot be expressed by a stem code alone. A postcoordinated
+expression is called a cluster expression.
+
+Cluster expressions are typically sourced from the WHO Electronic Coding
+Tool (ECT) at the point of care.
+
+#### Syntax
+
+A cluster expression combines a stem code with satellite codes using
+the `&` operator (combination) or `/` operator (specificity):
+```
+NC72.Z&XK8G&XJ7ZH&XJ7YM
+```
+
+Where:
+- `NC72.Z` — stem code: Fracture of femur, unspecified
+- `XK8G` — satellite: laterality
+- `XJ7ZH` — satellite: fracture subtype
+- `XJ7YM` — satellite: fracture open or closed
+
+#### FHIR Representation
+
+The stem code is carried in `Coding.code`. The full cluster expression
+is carried in the
+[ICD-11 Cluster Expression extension](StructureDefinition-icd11-cluster-expression.html)
+on the same `Coding` element:
+```json
+"code": {
+  "coding": [
+    {
+      "system": "http://id.who.int/icd/release/11/mms",
+      "code": "NC72.Z",
+      "display": "Fracture of femur, unspecified",
+      "extension": [
+        {
+          "url": "https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression",
+          "valueString": "NC72.Z&XK8G&XJ7ZH&XJ7YM"
+        }
+      ]
+    }
+  ],
+  "text": "Fracture of femur, unspecified — left, transverse, closed"
+}
+```
+
+The stem code in `Coding.code` SHALL match the leading stem code in the
+cluster expression string.
+
+#### Stem-Only vs Cluster
+
+| Scenario | Representation | Validation |
+|---|---|---|
+| Single stem code | `Coding.code` only | OCL `$validate-code` |
+| Postcoordinated expression | `Coding.code` + cluster extension | Cluster Validator |
+
+The cluster validator explicitly rejects stem-only expressions. Single
+stem codes SHALL be represented in `Coding.code` only and validated via
+OCL `$validate-code`.
+
+#### Satellite Code Class Restriction Exemption
+
+Satellite codes in a cluster expression are exempt from the
+Diagnosis/Finding class restriction that applies to stem codes in
+`Condition.code`. Substance, Anatomy, Organism, and other axis codes
+are valid and expected as satellites.
+
+#### Bangladesh ICD-11 Cluster Validator
+
+All postcoordinated cluster expressions SHALL be validated against the
+Bangladesh ICD-11 Cluster Validator prior to submission to the HIE:
+```
+POST https://icd11.dghs.gov.bd/cluster/validate
+Content-Type: application/json
+
+{"expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM"}
+```
+
+Example response:
+```json
+{
+  "valid": true,
+  "stem": {
+    "code": "NC72.Z",
+    "display": "Fracture of femur, unspecified",
+    "ocl_validated": true
+  },
+  "satellites": [
+    {"code": "XK8G",  "axis": "laterality",           "valid": true},
+    {"code": "XJ7ZH", "axis": "fractureSubtype",       "valid": true},
+    {"code": "XJ7YM", "axis": "fractureOpenOrClosed",  "valid": true}
+  ],
+  "errors": []
+}
+```
+
+The cluster validator is a mandatory HIE boundary gate. All vendor
+submissions containing postcoordinated ICD-11 expressions pass through it.
+
+---
+
+### Conformance Statements
+
+**ICD-11-CONF-01:** ICD-11 MMS codes SHALL use system URI
+`http://id.who.int/icd/release/11/mms`. Stem code validation is available
+via OCL at:
+`https://tr.ocl.dghs.gov.bd/api/fhir/CodeSystem/$validate-code?system=http://id.who.int/icd/release/11/mms&code={code}`
+
+**ICD-11-CONF-02:** The `icd11-cluster-expression` extension SHALL only
+be present when the expression contains at least one postcoordination
+satellite code using `&` or `/` operators. Single stem codes SHALL be
+represented in `Coding.code` only and validated via OCL `$validate-code`.
+
+**ICD-11-CONF-03:** Postcoordinated cluster expressions SHALL be validated
+against the Bangladesh ICD-11 Cluster Validator at
+`https://icd11.dghs.gov.bd/cluster/validate` prior to submission to the HIE.
+
+**ICD-11-CONF-04:** `Condition.code` SHALL contain at least one coding
+conforming to the `coding[stem]` slice with
+`system = http://id.who.int/icd/release/11/mms`. The stem code SHALL be
+a member of the Bangladesh ICD-11 MMS Condition ValueSet, which includes
+only Diagnosis and Finding class concepts. This restriction is enforced
+at runtime via OCL ValueSet `$validate-code`.
+
+**ICD-11-CONF-05:** Substance, Organism, Device, Anatomy, and Misc class
+ICD-11 concepts SHALL NOT appear as standalone stem codes in
+`Condition.code`. This restriction does not apply to satellite codes
+carried in the `icd11-cluster-expression` extension.

package-feed.xml

@@ -1,33 +0,0 @@
-<?xml version="1.0" encoding="UTF-8"?>
-<feed xmlns="http://www.w3.org/2005/Atom">
-  <id>https://fhir.dghs.gov.bd/core/package-feed.xml</id>
-  <title>Bangladesh Core FHIR IG Package Feed</title>
-  <subtitle>FHIR Package Feed for bd.fhir.core</subtitle>
-  <link rel="self" href="https://fhir.dghs.gov.bd/core/package-feed.xml"/>
-  <link rel="alternate" href="https://fhir.dghs.gov.bd/core/"/>
-  <updated>2025-10-02T00:00:00Z</updated>
-  <author>
-    <name>MIS, Directorate General of Health Services (DGHS), Bangladesh</name>
-    <uri>https://dghs.gov.bd</uri>
-  </author>
-  
-  <!-- Entries will be automatically added by the CI/CD pipeline -->
-  <!-- Example entry structure (will be generated): -->
-  <!--
-  <entry>
-    <title>bd.fhir.core version 0.2.0</title>
-    <link rel="alternate" href="https://fhir.dghs.gov.bd/core/0.2.0/"/>
-    <id>https://fhir.dghs.gov.bd/core/0.2.0/</id>
-    <updated>2025-10-02T00:00:00Z</updated>
-    <summary>Release 0.2.0 of Bangladesh Core FHIR Implementation Guide</summary>
-  </entry>
-  -->
-  
-  <entry>
-    <title>bd.fhir.core version 0.2.0</title>
-    <link rel="alternate" href="https://fhir.dghs.gov.bd/core/0.2.0/"/>
-    <id>https://fhir.dghs.gov.bd/core/0.2.0/</id>
-    <updated>2025-10-02T00:00:00Z</updated>
-    <summary>First draft release of Bangladesh Core FHIR Implementation Guide</summary>
-  </entry>
-</feed>

package-list.backup

@@ -1,23 +0,0 @@
-{
-  "package-id": "bd.fhir.core",
-  "title": "Bangladesh Core FHIR Implementation Guide",
-  "canonical": "https://fhir.dghs.gov.bd",
-  "introduction": "The Bangladesh Core FHIR IG defines national base profiles, value sets, and extensions for health data interoperability.",
-  "list": [
-    {
-      "version": "current",
-      "desc": "Continuous Integration Build (latest development version)",
-      "path": "https://fhir.dghs.gov.bd/build",
-      "status": "ci-build",
-      "current": true
-    },
-    {
-      "version": "v0.2.0",
-      "date": "2025-10-02",
-      "desc": "First draft release of the Bangladesh Core FHIR IG.",
-      "path": "https://fhir.dghs.gov.bd/v0.2.0",
-      "status": "trial-use",
-      "sequence": "STU 1"
-    }
-  ]
-}

package-list.json

@@ -11,10 +11,82 @@
       "status": "ci-build",
       "current": true
     },
+    {
+      "version": "0.4.5",
+      "date": "2026-04-10",
+      "desc": "minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.5/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.4",
+      "date": "2026-04-06",
+      "desc": "minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.4/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.3",
+      "date": "2026-04-06",
+      "desc": "minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.3/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.2",
+      "date": "2026-04-06",
+      "desc": "Patient profile minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.2/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.1",
+      "date": "2026-04-06",
+      "desc": "DGDA Drug and LOINC Integration with minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.1/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.4.0",
+      "date": "2026-04-06",
+      "desc": "DGDA Drug and LOINC Integration",
+      "path": "https://fhir.dghs.gov.bd/core/0.4.0/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.3.0",
+      "date": "2026-03-08",
+      "desc": "ICD-11 MMS integration and minor bug fixes",
+      "path": "https://fhir.dghs.gov.bd/core/0.3.0/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.2.5",
+      "date": "2025-10-06",
+      "desc": "Minor bug fix release",
+      "path": "https://fhir.dghs.gov.bd/core/0.2.5/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
+    {
+      "version": "0.2.4",
+      "date": "2025-10-06",
+      "desc": "Minor visual improvements",
+      "path": "https://fhir.dghs.gov.bd/core/0.2.4/",
+      "status": "trial-use",
+      "sequence": "STU 1"
+    },
     {
       "version": "0.2.3",
       "date": "2025-10-06",
-      "desc": "Second draft release of the Bangladesh Core FHIR IG",
+      "desc": "Minor documentation updates",
       "path": "https://fhir.dghs.gov.bd/core/0.2.3/",
       "status": "trial-use",
       "sequence": "STU 1"
@@ -22,7 +94,7 @@
     {
       "version": "0.2.2",
       "date": "2025-10-06",
-      "desc": "Second draft release of the Bangladesh Core FHIR IG",
+      "desc": "Minor bug fix release",
       "path": "https://fhir.dghs.gov.bd/core/0.2.2/",
       "status": "trial-use",
       "sequence": "STU 1"

publication-request.backup

@@ -1,12 +0,0 @@
-{
-  "package-id": "bd.fhir.core",
-  "title": "Bangladesh Core FHIR Implementation Guide",
-  "canonical": "https://fhir.dghs.gov.bd",
-  "version": "0.2.0",
-  "path": "https://fhir.dghs.gov.bd",
-  "status": "trial-use",
-  "sequence": "STU 1",
-  "mode": "milestone",
-  "desc": "First draft release of the Bangladesh Core FHIR IG.",
-  "first": true
-}

sushi-config.yaml

@@ -6,7 +6,7 @@ description: >
   This Implementation Guide defines the Bangladesh Core FHIR profiles,
   value sets, code systems, and implementation rules for national digital health systems.
 status: draft
-version: 0.2.4
+version: 0.3.0
 fhirVersion: 4.0.1
 copyrightYear: 2025+
 releaseLabel: CI Build
@@ -16,4 +16,4 @@ publisher:
   url: https://dghs.gov.bd
 parameters:
   logo: assets/images/001.svg
-  show-in-header: true
+  show-in-header: true