Resources are the building blocks of the FHIR standard. These resources convey the content of clinical records, identify patients or providers, or otherwise support information exchange between systems. These resources have been developed by numerous working groups at HL7, based on members' experience and subject expertise. The elements defined within FHIR resources are intended to capture and support those elements that 80% of implementers of a given resource are expected to support. Less frequently implemented elements are supported through FHIR's extensibility mechanisms. The list of all available resources in the FHIR R4 standard can be found here.
Following are the 'Profiles' supported by this implementation guide:
|Resource Type||Description||Sample Messages (JSON)|
|Appointment||The Appointment is used to provide information about a planned meeting that may be in the future/past||JSON|
|Bundle||The main resource submitted to the target referral system||JSON|
|Communication||Provides additional information about the service outcomes.||JSON|
|Condition||Primary Diagnosis for referral||JSON|
|Consent||Any consent information collected at source||JSON|
|DocumentReference||Any additional PDF forms/documents that have to be included as documents.||JSON|
|Location||Location includes both incidental locations (a place which is used for healthcare without prior designation or authorization) and dedicated, formally appointed locations.||JSON|
|MessageHeader||Provides details for message execution. Identifies the destination and the other of the referral bundle. It can also provide a general reason for referral in case the included ServiceRequest resources are very specific.||JSON|
|OperationOutcome||Operation outcomes are sets of error, warning and information messages that provide detailed information about the outcome of an attempted system operation.||JSON|
|Organization||Identifies the recipient HCC (PractitionerRole.organization) in the MessageHeader. Could also appear in other PractitionerRole.organization references.||JSON|
|Patient||The subject of the referral request||JSON|
|Practitioner||Provides the requester identity (PractitionerRole.practitioner). Also, in case the author is not the requester the author reference in the MessageHeader may refer to a second Practitioner resource.||JSON|
|PractitionerRole||Defines the requester. Should reference one Practitioner or one Organization resource. Also referenced in other resources.||JSON|
|QuestionnaireResponse||A list of nested Questions and Answers items that complement the Service Request order details||JSON|
|ServiceRequest||The main payload resource(s)||JSON|
|Task||Provides additional status information about the referral and referral update reasons, in case the referral needs to be updated or cancelled by Source||JSON|
The eReferral message payload has specific composition according to the direction of the message:
It's composition is depicted below:
The resource cannot be rendered.
It is mandatory that each Bundle message should contain at least one instance of the following resource types: MessageHeader, ServiceRequest, Patient and PractitionerRole.
The bundle can contain multiple ServiceRequest resources, one for each service offering. The ServiceRequest along with the QuestionnaireResponse resource provide most of the service information required to provision the service in CHRIS. Documents, such PDF documents, can be attached to the bundle, if included by the provider at referral time. In this case the document content will be embedded in one or more DocumentReference resources as a base64 encoded binary payload.
It's composition is depicted in the diagram below:
The resource cannot be rendered.
Following are the Extensions supported by this implementation guide:
|CommunicationBarrier||The extension is required to identify if the patient speaks/understands an offical language (english/french), or if she/he does not an interpretor is required.||Download XML/JSON|
|HCNVersionCode||An assigned sequence code, uniquely identifying a Health Card issued (or potentially issued) to a Registered Person||Download XML/JSON|
|RoutingOptions||This is an extension required for Referral Source Type identification. Only one referral routing object expected.||Download XML/JSON|
|ReferralSourceType||The purpose of this extension is to support multiple locations for a requester for family doc or provider.||Download XML/JSON|
|PatientPresentLocation||To specify the present location of the patient.||Download XML/JSON|
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