Care Contexts & Linking

How episodes of care get attached to a patient's ABHA — the foundation for all data sharing.

A care context is a reference to an episode of care in your system — an outpatient visit, an admission, a lab order. Linking a care context to a patient's ABHA is what makes that episode discoverable and shareable later.

Patient (ABHA address)
└── Patient reference (your MRN)          ← per HIP
    ├── Care context: OPD-2025-01-15      ← an OPD visit
    ├── Care context: IPD-2025-02-03      ← an admission
    └── Care context: LAB-2025-02-10      ← a lab report

Only references (IDs + display names) are linked to the CM — the actual clinical data stays in your system until a consent-based data flow occurs.

Linking flows

HIP-initiated linking (recommended)

After you verify the patient's ABHA at the point of care (Milestone 1), link new episodes automatically:

sequenceDiagram
  participant HIP as HIP (your HMIS)
  participant GW as Gateway
  participant CM as HIE-CM
  HIP->>HIP: verify patient's ABHA (OTP / QR / demographic)
  HIP->>GW: link care context (with link token)
  GW->>CM: forward
  CM-->>GW: success
  GW->>HIP: on-link confirmation
  CM->>CM: notify patient (record added)

In the v3 APIs, ABHA verification yields a link token for the patient, which authorises subsequent link/carecontext calls without further patient interaction. Demographic-auth based linking exists for assisted flows.

Patient-initiated linking (discovery)

The patient, from their PHR app, searches a facility for their records:

CM sends your HIP a discovery request (care-contexts/discover) with the patient's demographics + identifiers.
Your HIP matches the patient (fuzzy match on name/gender/YOB, exact on verified mobile/ABHA) and responds with unlinked care contexts (on-discover).
CM asks your HIP to initiate authentication (link/init) — you typically send an OTP to the patient's registered mobile.
Patient enters the OTP in their PHR app; CM passes it to your HIP (link/confirm); on success the contexts are linked.

Matching matters

Discovery matching is a certification focus: return only high-confidence matches, never leak other patients' data, and respond with an empty result rather than a wrong one. Log every discovery request for audit.

New episodes for already-linked patients

When a linked patient has a new visit, link the new care context and the CM notifies the patient ("Sunrise Hospital added a new record"). Keep display names human-friendly — patients see them verbatim in their PHR app:

Care context display

{
  "patientReference": "MRN-2024-0042",
  "careContextReference": "OPD-2025-01-15",
  "display": "OPD Consultation — General Medicine, 15 Jan 2025"
}

Link care contexts as soon as episodes are created, and include the HI types each context will provide — it improves the patient's consent experience and narrows requests to relevant contexts.

For API payloads, see the Milestone 2 guides for HIP-initiated linking and Discovery & Link.

Sources

ABDM Proposed Simplified Milestone 2 (DOCX→MD, 2026-08)

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