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201809 VA Closed-Loop Referrals

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VA Closed-Loop Referrals

Submitting WG/Project/Implementer Group


The U.S. Office of the National Coordinator for Health Information Technology (ONC) organized the 360Exchange (360X) Project to accelerate interoperable health care data exchange in heterogeneous EHRT environments. In particular, the 360X Project seeks to enable providers to exchange the following types of clinical information from within their EHRT workflow, regardless of the EHRT used:

  • Referral requests containing relevant patient clinical information
  • Result of referral containing relevant patient clinical information

Whereas the 360X Project emphasized C-CDA content and Direct transport infrastructure, this connectathon track focuses on fulfilling these requirements using FHIR resources, REST architecture for transport, and OAuth2 for security.

Proposed Track Leads


Expected participants

The following organizations have indicated an interest in participating in this track:

  • Veterans Health Administration (VHA)
  • Your organization here!


FHIR Data Server

A FHIR server (version 3.0) should support the following resources for closed-loop referral workflow, in addition to core clinical data (Patient, Observation, etc):

Optional Resources:

A FHIR server is available for testing with sample data that represent one or more care plan scenarios.

  • HSPC sandbox server (FHIR 3.0.1) at Endpoint TBD

FHIR Knowledge Asset Server

A FHIR server (version 3.0) should support the following resources for knowledge-based care management:

  • PlanDefinition, ActivityDefinition, Library

Clinical Scenarios

Technical Scenarios

Retrieve a patient's care plan(s)