ReferralRequest FHIR Resource Proposal

Referral and Transfer of Care Request

This resource defines the information structure and related components to support the initiation of a request for referral and transfer of a patient to the care of another carer/provider

Owning committee name

Patient Care

Contributing or Reviewing Work Groups

• Workgroup: Patient Care

• Project wiki link: Referral and Transition/Transfer of Care

FHIR Resource Development Project Insight ID

Pending

Scope of coverage

• In scope:

- Patients (especially those with complex health conditions) are care for by multi-disciplinary health care teams. They may also be transitioned between different health care settings (e.g. from acute care to rehabilitation or long term care/skilled nursing facilities). The referral and transition of care processes with appropriate supporting documents are required to initiate and complete these processes

- The referral and transfer of care request resources will be designed to enable exchange of crucial administrative and clinical information to request the initiation of the referral process

- Administrative data are likely to include: Patient details, provider and provider organisation details (and others to be identified)

- It is not uncommon for "care plan" or components of care plan to be included in a referral or transition of care information package

• Out of scope:

- While it pathology and imaging studies requests are increasingly considered as a specialization of referral, until there is industry wide agreement on this thinking, such requests should use the Diagnostic Order resources

http://www.hl7.org/implement/standards/fhir/diagnosticorder.html

RIM scope

• Patient Care D-MIM and R-MIMs
• Others???

Resource appropriateness

Referral and Transition of Care are two critical processes and information requirements in continuity of care, collaborative care and transition of care for patients among different health care settings and facilities

Expected implementations

• As referral and transition of care messages

• As Referral Note CDA documents and CCD

Content sources

• Patient Care - Care Provision/Care Transfer Models
• C-CDA Referral Note and CCD templates
• IHE PCC
• Other international sources: e.g. NHS, Australia (NEHTA)

Resource Relationships

• Patient Resource as the "subject of Care"

• Provider and Organization Resources as the "author" and "recipient(s)"

• Clinical Resources include:

- Condition/Concern

- Family History

- Observation

- Allergy/Intolerance, Adverse Reaction

- Medication (including Medication, Prescription, Dispense, Medication Statement, Immunization, Immunization Recommendation)

- Procedure

- Diagnostic Order, Diagnostic Report, Imaging Report

- Care Plan

Timelines

• Referral/Care Transition resources development - Aug/Sept 2014
• Referral/Care Transition resources ready for QA - Prior to Sept 2014 WGM for QA process
• Content ready for inclusion in FHIR DSTU ballot - January 2015
• Ballot content published as part of next DSTU - March 2015
• PCWG FHIR Clinical Resources to align with/inform use of relevant C-CDA templates - May 2015

gForge Users

• Stephen Chu

• David Hay