DRAFT - The specification is currently in development and subject to significant change. It is not ready for limited roll-out or production level use.

Term / Acronym Meaning
API Application Programming Interface
Central Intake Single entry for eReferrals that passes referral requests from the eReC Source to one or multiple eReC Target destinations. The Central Intake dispatches the messages received from the original eReC Source using mechanisms for message Routing, Splitting and Chaining.
Central Infrastructure A Central Infrastructure collects health information from participating organizations and stores the information in a centralized place. The Infrastructure also provides access control. Typically, the Central Infrastructure is under jurisdictional control.
Chaining Chaining is the mechanism used by the Central Intake when a referral is received, and after a service is performed, it results in one or more additional new distinct requests for downstream services created to fulfill the initially requested service. Chaining occurs after a service is performed, and the need was identified for additional services.
eConsult Electronic request from a physician to receive advice from a specialist (i.e., provider-to-provider consultation)
Enables asynchronous electronic communication between the requesting physician and specialist.
eReC Dispatcher The eReC Dispatcher is the technical actor that supports Central Intake architectures of eReferral/eConsult exchanges. The eReC Dispatcher performs triaging and transferring of the eReC Messages, using Routing and Splitting methods.

As part of triaging, eReC Dispatcher may have additional capabilities, such as processing the eReferral/eConsult request, as well as deciding and passing it on to the most appropriate destination (eReC Receiver). Processing includes analysis of referral request needs, urgency, downstream service wait times, location and may include consideration for patient preference for location, waiting period and health care provider.

The eReC Dispatcher is an internal facing actor, that does not directly participate in interoperability data exchanges.
eReC Receiver The eReC Receiver is the technical actor that receives and responds where appropriate to the FHIR Messages sent by the eReC Sender. It also produces and sends FHIR Messages to the eReC Sender, in support of the activities related to processing eReferral/eConsult requests and performing the requested services.
eReC Sender The eReC Sender is the technical actor that produces and sends FHIR Messages to the eReC Receiver, in support of the activities related to requesting eReferral/eConsult services. It also receives and responds where appropriate to the FHIR Messages sent by the eReC Receiver.
eReC Source eReferral/eConsult Source. Used by Requester HCP to initiate, monitor and communicate about the referral/consultation request.
eReC Target eReferral/eConsult Target. Used by Performer HCP to receive, respond to, manage and communicate about the referral/consultation request and associated tasks.
eReferral Electronic request for a patient to receive care from a specialist or other services (e.g., home or community care, diagnostic exam, etc.)
Patient referrals are created, submitted, tracked and managed electronically.
HCP Healthcare Provider
Health Service Directory Used by HCP or service provider to discover services and service providers to address eReferral needs. RMS typically bundle in HSD functionality to better support referral/consult workflows, or in cases where the POS system has the required capabilities to support the referral/consult workflow, the HSD could be centrally managed (i.e. jurisdictional) or provided by a 3rd party and integrated with the POS system. An HSD may provide one or more of multiple functions, including:
Health service discovery mechanisms;
Health service definition hosting and data federation services;
Integration with a forms repository to associate health services with forms used to support the referral process;
HL7® Fast Healthcare Interoperability Resources (FHIR®) Expected to be a next generation standards framework created by HL7. FHIR® combines the best features of HL7‘s Version 2, Version 3 and product lines while leveraging the latest web standards and applying a tight focus on implementability. (Source: http://www.hl7.org/implement/standards/fhir/)
Patient Portal A patient portal is a web-based access point that enables secure patient access to personal health information and other self-serve health IT services. For example, a patient portal can be hosted on an EMR solution.
Performer HCP A Health Care Provider or delegate (e.g. medical office assistant), or other service provider that receives the referral request and performs the requested services
POS A Point of Service system. Used by HCPs to view and manage personal health information (PHI). These systems include hospital information systems (HIS), primary care electronic medical record systems (EMR), community and ambulatory health information systems, and provincial/regional EHR viewers. May also be called a Point of Care system (POC).
Requester HCP A Health Care Provider or delegate (e.g. medical office assistant), or other service provider that initiates the eReferral workflow for a patient by sending a referral request.
RMS Referral Management System. Supports the exchange of referral requests between Requester HCP and Performer HCP where one or both of their POS systems do not have the required capabilities to support the workflow. Capabilities can be implemented as API services and\or interactive applications and a single system may provide one or more capabilities to enable and or enhance eReferral workflows. They can also be considered helper apps.
Routing Routing is the mechanism used by the Central Intake when a referral is received and passed to a new handler or destination as the same referral as the original. Routing occurs before a service is performed.
Splitting Splitting is the mechanism used by the Central Intake when a referral that contains several different services gets split into multiple referrals for processing.
Terminology Collection of uniquely identifiable concepts with associated representations, designations, associations and meanings.