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4.8 Resource ReferralRequest - Content

This resource maintained by the Patient Care Work Group

Used to record and send details about a request for referral service or transfer of a patient to the care of another provider or provider organisation.

4.8.1 Scope and Usage

This resource is used to record relevant information required to support a referral request or a transfer of care request from one provider or provider organisation to another. It is intended for use when a patient is required to be referred to another provider (e.g. a specialist) for a consultation/second opinion, for short term or longer term management of one or more health issues or problems. It is also intended for use when a complete and more permanent transfer of care responsibility from one provider/organization to another. For example as in the case of requesting the transfer of care for a patient from acute care setting to rehabilitation, aged care, or skilled nursing facility.

4.8.2 Boundaries and Relationships

The Referral Request resource references or includes a number of other resources including Practitioner, Organization, Condition, Family History, Allergy/Intolerance, Alerts, Medication, Diagnostic Reports, Care Plan, etc

This resource is referenced by Care Plan (for example, a rheumatoid arthritis care plan may include referrals to rheumatologist, physiotherapist, occupational therapist).

4.8.3 Background and Context

Provides additional detail on exactly how the resource is to be used

This resource is referenced by CarePlan2, Claim, ClinicalImpression, Encounter and EpisodeOfCare

4.8.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ReferralRequest DomainResourceA request for referral or transfer of care
... status ?! Σ1..1codedraft | sent | active | cancelled | rejected | completed
ReferralStatus (Required)
... identifier 0..*IdentifierIdentifier of request
... type Σ0..1CodeableConceptReferral/Transition of care request type
... specialty 0..1CodeableConceptThe clinical specialty (discipline) that the referral is requested for
... priority Σ0..1CodeableConceptUrgency of referral / transfer of care request
... patient Σ0..1PatientPatient referred to care or transfer
... requester Σ0..1Practitioner | Organization | PatientRequester of referral / transfer of care
... recipient Σ0..*Practitioner | OrganizationReceiver of referral / transfer of care request
... encounter 0..1EncounterEncounter
... dateSent Σ0..1dateTimeDate referral/transfer of care request is sent
... reason Σ0..1CodeableConceptReason for referral / Transfer of care request
... description 0..1stringA textual description of the referral
... serviceRequested Σ0..*CodeableConceptService(s) requested
... supportingInformation Σ0..*AnyAdditonal information to support referral or transfer of care request
... fulfillmentTime Σ0..1PeriodRequested service(s) fulfillment time

UML Diagram

ReferralRequest (DomainResource)The workflow status of the referral or transfer of care request (this element modifies the meaning of other elements)status : code 1..1 « The status of the referralReferralStatus »Business Id that uniquely identifies the referral/care transfer request instanceidentifier : Identifier 0..*An indication of the type of referral (or where applicable the type of transfer of care) requesttype : CodeableConcept 0..1Indication of the clinical domain or discipline to which the referral or transfer of care request is sentspecialty : CodeableConcept 0..1An indication of the urgency of referral (or where applicable the type of transfer of care) requestpriority : CodeableConcept 0..1The patient who is the subject of a referral or transfer of care requestpatient : Reference(Patient) 0..1The healthcare provider or provider organization who/which initaited the referral/transfer of care request. Can also be Patient (a self referral)requester : Reference(Practitioner|Organization| Patient) 0..1The healthcare provider(s) or provider organization(s) who/which is to receive the referral/transfer of care requestrecipient : Reference(Practitioner|Organization) 0..*The encounter at which the request for referral or transfer of care is initiatedencounter : Reference(Encounter) 0..1Date/DateTime the request for referral or transfer of care is sent by the authordateSent : dateTime 0..1Description of clinical condition indicating why referral/transfer of care is requestedreason : CodeableConcept 0..1The reason gives a short description of why the referral is being made, the description expands on this to support a more complete clinical summarydescription : string 0..1The service(s) that is/are requested to be provided to the patientserviceRequested : CodeableConcept 0..*Any additional (administrative, financial or clinical) information required to support request for referral or transfer of caresupportingInformation : Reference(Any) 0..*The period of time within which the services identified in the referral/transfer of care is specified or required to occurfulfillmentTime : Period 0..1

XML Template

<ReferralRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <status value="[code]"/><!-- 1..1 draft | sent | active | cancelled | rejected | completed -->
 <identifier><!-- 0..* Identifier Identifier of request --></identifier>
 <type><!-- 0..1 CodeableConcept Referral/Transition of care request type --></type>
 <specialty><!-- 0..1 CodeableConcept 
     The clinical specialty (discipline) that the referral is requested for --></specialty>
 <priority><!-- 0..1 CodeableConcept Urgency of referral / transfer of care request --></priority>
 <patient><!-- 0..1 Reference(Patient) Patient referred to care or transfer --></patient>
 <requester><!-- 0..1 Reference(Practitioner|Organization|Patient) 
     Requester of referral / transfer of care --></requester>
 <recipient><!-- 0..* Reference(Practitioner|Organization) 
     Receiver of referral / transfer of care request --></recipient>
 <encounter><!-- 0..1 Reference(Encounter) Encounter --></encounter>
 <dateSent value="[dateTime]"/><!-- 0..1 Date referral/transfer of care request is sent -->
 <reason><!-- 0..1 CodeableConcept Reason for referral / Transfer of care request --></reason>
 <description value="[string]"/><!-- 0..1 A textual description of the referral -->
 <serviceRequested><!-- 0..* CodeableConcept Service(s) requested --></serviceRequested>
 <supportingInformation><!-- 0..* Reference(Any) 
     Additonal information to support referral or transfer of care request --></supportingInformation>
 <fulfillmentTime><!-- 0..1 Period Requested service(s) fulfillment time --></fulfillmentTime>
</ReferralRequest>

JSON Template

{doco
  "resourceType" : "ReferralRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "status" : "<code>", // R!  draft | sent | active | cancelled | rejected | completed
  "identifier" : [{ Identifier }], // Identifier of request
  "type" : { CodeableConcept }, // Referral/Transition of care request type
  "specialty" : { CodeableConcept }, // 
     The clinical specialty (discipline) that the referral is requested for
  "priority" : { CodeableConcept }, // Urgency of referral / transfer of care request
  "patient" : { Reference(Patient) }, // Patient referred to care or transfer
  "requester" : { Reference(Practitioner|Organization|Patient) }, // 
     Requester of referral / transfer of care
  "recipient" : [{ Reference(Practitioner|Organization) }], // 
     Receiver of referral / transfer of care request
  "encounter" : { Reference(Encounter) }, // Encounter
  "dateSent" : "<dateTime>", // Date referral/transfer of care request is sent
  "reason" : { CodeableConcept }, // Reason for referral / Transfer of care request
  "description" : "<string>", // A textual description of the referral
  "serviceRequested" : [{ CodeableConcept }], // Service(s) requested
  "supportingInformation" : [{ Reference(Any) }], // 
     Additonal information to support referral or transfer of care request
  "fulfillmentTime" : { Period } // Requested service(s) fulfillment time
}

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ReferralRequest DomainResourceA request for referral or transfer of care
... status ?! Σ1..1codedraft | sent | active | cancelled | rejected | completed
ReferralStatus (Required)
... identifier 0..*IdentifierIdentifier of request
... type Σ0..1CodeableConceptReferral/Transition of care request type
... specialty 0..1CodeableConceptThe clinical specialty (discipline) that the referral is requested for
... priority Σ0..1CodeableConceptUrgency of referral / transfer of care request
... patient Σ0..1PatientPatient referred to care or transfer
... requester Σ0..1Practitioner | Organization | PatientRequester of referral / transfer of care
... recipient Σ0..*Practitioner | OrganizationReceiver of referral / transfer of care request
... encounter 0..1EncounterEncounter
... dateSent Σ0..1dateTimeDate referral/transfer of care request is sent
... reason Σ0..1CodeableConceptReason for referral / Transfer of care request
... description 0..1stringA textual description of the referral
... serviceRequested Σ0..*CodeableConceptService(s) requested
... supportingInformation Σ0..*AnyAdditonal information to support referral or transfer of care request
... fulfillmentTime Σ0..1PeriodRequested service(s) fulfillment time

UML Diagram

ReferralRequest (DomainResource)The workflow status of the referral or transfer of care request (this element modifies the meaning of other elements)status : code 1..1 « The status of the referralReferralStatus »Business Id that uniquely identifies the referral/care transfer request instanceidentifier : Identifier 0..*An indication of the type of referral (or where applicable the type of transfer of care) requesttype : CodeableConcept 0..1Indication of the clinical domain or discipline to which the referral or transfer of care request is sentspecialty : CodeableConcept 0..1An indication of the urgency of referral (or where applicable the type of transfer of care) requestpriority : CodeableConcept 0..1The patient who is the subject of a referral or transfer of care requestpatient : Reference(Patient) 0..1The healthcare provider or provider organization who/which initaited the referral/transfer of care request. Can also be Patient (a self referral)requester : Reference(Practitioner|Organization| Patient) 0..1The healthcare provider(s) or provider organization(s) who/which is to receive the referral/transfer of care requestrecipient : Reference(Practitioner|Organization) 0..*The encounter at which the request for referral or transfer of care is initiatedencounter : Reference(Encounter) 0..1Date/DateTime the request for referral or transfer of care is sent by the authordateSent : dateTime 0..1Description of clinical condition indicating why referral/transfer of care is requestedreason : CodeableConcept 0..1The reason gives a short description of why the referral is being made, the description expands on this to support a more complete clinical summarydescription : string 0..1The service(s) that is/are requested to be provided to the patientserviceRequested : CodeableConcept 0..*Any additional (administrative, financial or clinical) information required to support request for referral or transfer of caresupportingInformation : Reference(Any) 0..*The period of time within which the services identified in the referral/transfer of care is specified or required to occurfulfillmentTime : Period 0..1

XML Template

<ReferralRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <status value="[code]"/><!-- 1..1 draft | sent | active | cancelled | rejected | completed -->
 <identifier><!-- 0..* Identifier Identifier of request --></identifier>
 <type><!-- 0..1 CodeableConcept Referral/Transition of care request type --></type>
 <specialty><!-- 0..1 CodeableConcept 
     The clinical specialty (discipline) that the referral is requested for --></specialty>
 <priority><!-- 0..1 CodeableConcept Urgency of referral / transfer of care request --></priority>
 <patient><!-- 0..1 Reference(Patient) Patient referred to care or transfer --></patient>
 <requester><!-- 0..1 Reference(Practitioner|Organization|Patient) 
     Requester of referral / transfer of care --></requester>
 <recipient><!-- 0..* Reference(Practitioner|Organization) 
     Receiver of referral / transfer of care request --></recipient>
 <encounter><!-- 0..1 Reference(Encounter) Encounter --></encounter>
 <dateSent value="[dateTime]"/><!-- 0..1 Date referral/transfer of care request is sent -->
 <reason><!-- 0..1 CodeableConcept Reason for referral / Transfer of care request --></reason>
 <description value="[string]"/><!-- 0..1 A textual description of the referral -->
 <serviceRequested><!-- 0..* CodeableConcept Service(s) requested --></serviceRequested>
 <supportingInformation><!-- 0..* Reference(Any) 
     Additonal information to support referral or transfer of care request --></supportingInformation>
 <fulfillmentTime><!-- 0..1 Period Requested service(s) fulfillment time --></fulfillmentTime>
</ReferralRequest>

JSON Template

{doco
  "resourceType" : "ReferralRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "status" : "<code>", // R!  draft | sent | active | cancelled | rejected | completed
  "identifier" : [{ Identifier }], // Identifier of request
  "type" : { CodeableConcept }, // Referral/Transition of care request type
  "specialty" : { CodeableConcept }, // 
     The clinical specialty (discipline) that the referral is requested for
  "priority" : { CodeableConcept }, // Urgency of referral / transfer of care request
  "patient" : { Reference(Patient) }, // Patient referred to care or transfer
  "requester" : { Reference(Practitioner|Organization|Patient) }, // 
     Requester of referral / transfer of care
  "recipient" : [{ Reference(Practitioner|Organization) }], // 
     Receiver of referral / transfer of care request
  "encounter" : { Reference(Encounter) }, // Encounter
  "dateSent" : "<dateTime>", // Date referral/transfer of care request is sent
  "reason" : { CodeableConcept }, // Reason for referral / Transfer of care request
  "description" : "<string>", // A textual description of the referral
  "serviceRequested" : [{ CodeableConcept }], // Service(s) requested
  "supportingInformation" : [{ Reference(Any) }], // 
     Additonal information to support referral or transfer of care request
  "fulfillmentTime" : { Period } // Requested service(s) fulfillment time
}

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire

4.8.4.1 Terminology Bindings

PathDefinitionTypeReference
ReferralRequest.status The status of the referralRequiredhttp://hl7.org/fhir/referralstatus

4.8.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
patientreferenceWho the referral is aboutReferralRequest.patient
(Patient)
prioritytokenThe priority assigned to the referralReferralRequest.priority
recipientreferenceThe person that the referral was sent toReferralRequest.recipient
(Organization, Practitioner)
requesterreferenceRequester of referral / transfer of careReferralRequest.requester
(Patient, Organization, Practitioner)
specialtytokenThe specialty that the referral is forReferralRequest.specialty
statustokenThe status of the referralReferralRequest.status
typetokenThe type of the referralReferralRequest.type