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The Ontario eReferral FHIR Implementation Guide covers the referral patterns for various pathways such as an EMR integration with a Regional Home to Community Care Solution, Primary Care to Home and Community Care, Acute Care, etc.

This implementation guide describes the business considerations and implementation details for enabling interoperability between two referral systems to initiate and manage an electronic referral.

Following patterns have been provided in this release of the implementation guide to facilitate referral workflow:

(1) SMART on FHIR messaging pattern where a Referral Management System (RMS) is directly launched in clinician’s Point of Service (POS) system and enables users to complete the initial eReferral request, including the initial appointment date and time; or

(2) Direct API Integration/Submission where two RMSs exchange referral messages (e.g., initial eReferral request, appointment updates, communications and notifications) via FHIR-based API interfaces.

Out of scope

At this time, the implementation guide does not cover:

  • Communication with a health services directory to expand the list of services/providers that can be searched

  • Integration with Ontario digital health assets such as Provincial Client Registry

  • Communication of outcome of the eReferral (i.e. consultation report)

  • Semantically interoperable eReferral form templates and/or content

  • Chained, forwarded or recursive eReferrals in which an eReferral message is sent from system A to system B and then the message either is forwarded on to system C or leads to multiple related eReferrals to be created and managed (e.g. a centralized intake request leads to multiple service referrals)