Why Your ABDM FHIR Bundles Show NA in PHR: 13 Fixes for NRCES Compliance

You pushed health records to ABDM. The PHR app shows them. But every clinical field shows NA — no patient name, no practitioner, no clinic. This is the second most common ABDM integration problem after encryption.

Before vs After

Why Fields Show NA

• Patient Name: Missing Patient resource or wrong Composition.subject reference
• Practitioner: Missing Practitioner or Composition.author not set
• Clinic: Missing Organization resource or Composition.custodian not set
• Gender, DOB: Patient resource lacks fields

Correct Bundle Structure

1. Composition — MUST be first entry (FHIR invariant bdl-11)
2. Practitioner — Composition.author
3. Organization — Composition.custodian with HFR facility ID
4. Patient — Composition.subject with ABHA identifier
5. Encounter — Composition.encounter
6. Clinical resources — Condition, Observation, etc.

The 13 Fixes

1. References Must Use urn:uuid:

// WRONG
"subject": { "reference": "Patient/abc-123" }

// CORRECT
"subject": { "reference": "urn:uuid:abc-123", "display": "Patient Name" }

2. Bundle.identifier Required

"identifier": { "system": "http://hip.in", "value": "unique-id" }

3. Bundle.timestamp Required

"timestamp": "2026-03-20T10:30:00.000Z"

4. Organization with HFR Facility ID

{
  "resourceType": "Organization",
  "identifier": [{
    "system": "https://facility.ndhm.gov.in",
    "value": "IN2710004770"
  }],
  "name": "Your Hospital"
}

5. Composition.custodian

"custodian": { "reference": "urn:uuid:org-id", "display": "Hospital Name" }

6. Composition.type Uses SNOMED

"type": { "coding": [{ "system": "http://snomed.info/sct", "code": "371530004" }] }

7. Every Resource Needs meta.profile

"meta": { "profile": ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"] }

8. Patient Identifier with MR Type

"identifier": [{
  "type": { "coding": [{ "code": "MR" }] },
  "system": "https://healthid.ndhm.gov.in",
  "value": "91-7345-1816-0779"
}]

9-13: Display Text, versionId, Bundle Profile, Composition ID, Encounter

Every reference needs display. Bundle needs meta.versionId and meta.profile: DocumentBundle. Composition needs identifier and encounter.

SNOMED Codes by Record Type

Need Help?

At Nirmitee, we build NRCES-compliant FHIR bundles for all 7 HI types. Our TypeScript SDK generates compliant bundles automatically. Contact us.