Example - Ontario eReferral

Summary

SMART on FHIR (SOF) in an eReferral workflow enables sending providers to send a referral without leaving their native POS. This allows a user to click a pre-configured button within their POS, which launches and lands a user within a different application, such as Ocean to send an eReferral. Additionally, by providing users with patient context, certain fields can be pulled from their native POS and automatically populated within an eReferral form. A typical user story is as follows: As a sending provider, I want the ability to send a referral with patient context without leaving my native system.

Use Case 1 - EHR: Telus CHR – eReferral Sender Workflow using Ocean

Step Description
1. Sending provider begins in CHR within a patient record of which they want to submit a referral for.
2. The sending providers will create, order, and add relevant attachments and click the Ocean button.
3. A new browser window opens, and the sending provider lands on the Ocean Healthmap.
4. The sending provider searches for a referral target and selects the specified service.
5. The referral form appears, and the following fields are autocompleted:
-Patient demographic fields are filled in.
- Attachments are added.
6. The sending provider submits the eReferrals.
7. The new eReferral is saved as a PDF within CHR.

Key Components of this use case:

Limitations:

  • $everything does not pull CPP.
  • Status updates from Ocean to CHR are not fully supported by CHR.
  • Only the initial appointment update is received by CHR.
    • Appointment updates and/or cancellations are not supported.
  • Provider messaging functionality is not supported.
    • A user must launch into Ocean and use the messaging functionality.

Use Case 2 - EPIC – eReferral Sender Workflow

Step Description
1. Sending provider begins in EPIC, on a patient record, navigates to the encounters tab.
2. The sending provider will initiate the eReferral by clicking the Ocean button.
3. A new browser window opens, and the sending provider lands on the Ocean Healthmap.
4. The sending provider searches for a referral target and selects the specified service.
5. The referral form appears, and the following fields are autocompleted:
- Patient demographic fields are filled in.
6. The sending provider submits the eReferrals.
7. The new eReferral is saved as a PDF within EPIC.

Key Components of this use case:

Limitations:

  • Users must manually download any eReferral attachments and upload them in EPIC.
  • Users must transcribe certain information from EPIC UI.
  • eReferral updates do not flow into EPIC.
  • Appointments do not flow into EPIC.
  • Provider communications do not flow into EPIC.

There are a few existing eReferral workflows that leverage the SOF functionality. These workflows may vary depending on a few aspects:

  • The ability for a system to pull or read information from another.
  • The level of integration between systems.
  • The overall conformance a system has with the Canadian FHIR specification.

Possible Future Use Case

Providers often receive referrals in an RMS and want to get these referrals into their POS. Getting the referral into a POS using a SMART integration would allow for the POS to have referral information from the RMS which would enable the option for a POS to build out other integrations for further data flow between the systems such as appointment information being kept in sync between the POS and the RMS.