Profile: CareConnect-GPC-ReferralRequest-1
ReferralRequest | |||
Short | A request for referral or transfer of care | ||
Definition | 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 organization. | ||
Cardinality | 0..* | ||
Alias | ReferralRequest TransferOfCare Request | ||
Constraints |
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Mappings |
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ReferralRequest.id | |||
Short | Logical id of this artifact | ||
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||
Cardinality | 0..1 | ||
Type | id | ||
Summary | True | ||
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||
ReferralRequest.meta | |||
Short | Metadata about the resource | ||
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource. | ||
Cardinality | 0..1 | ||
Type | Meta | ||
Summary | True | ||
ReferralRequest.meta.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
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ReferralRequest.meta.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
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ReferralRequest.meta.versionId | |||
Short | Version specific identifier | ||
Definition | The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted. | ||
Cardinality | 0..1 | ||
Type | id | ||
Summary | True | ||
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. | ||
ReferralRequest.meta.lastUpdated | |||
Short | When the resource version last changed | ||
Definition | When the resource last changed - e.g. when the version changed. | ||
Cardinality | 0..1 | ||
Type | instant | ||
Summary | True | ||
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. | ||
ReferralRequest.meta.profile | |||
Short | Profiles this resource claims to conform to | ||
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. | ||
Cardinality | 1..* | ||
Type | uri | ||
Summary | True | ||
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. | ||
ReferralRequest.meta.security | |||
Short | Security Labels applied to this resource | ||
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. | ||
Cardinality | 0..* | ||
Type | Coding | ||
Binding | Security Labels from the Healthcare Privacy and Security Classification System. | ||
Summary | True | ||
Comments | The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. | ||
ReferralRequest.meta.tag | |||
Short | Tags applied to this resource | ||
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. | ||
Cardinality | 0..* | ||
Type | Coding | ||
Binding | Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones" | ||
Summary | True | ||
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. | ||
ReferralRequest.implicitRules | |||
Short | A set of rules under which this content was created | ||
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. | ||
Cardinality | 0..1 | ||
Type | uri | ||
Modifier | True | ||
Summary | True | ||
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation. | ||
ReferralRequest.language | |||
Short | Language of the resource content | ||
Definition | The base language in which the resource is written. | ||
Cardinality | 0..1 | ||
Type | code | ||
Binding | A human language. Binding extensions
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Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||
ReferralRequest.text | |||
Short | Text summary of the resource, for human interpretation | ||
Definition | A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||
Cardinality | 0..1 | ||
Type | Narrative | ||
Alias | narrative, html, xhtml, display | ||
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: dom-1 | ||
Mappings |
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ReferralRequest.contained | |||
Short | Contained, inline Resources | ||
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||
Cardinality | 0..* | ||
Type | Resource | ||
Alias | inline resources, anonymous resources, contained resources | ||
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. | ||
Mappings |
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ReferralRequest.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) | ||
Mappings |
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ReferralRequest.extension:ReferralRequestMethod | |||
Short | Optional Extensions Element | ||
Definition | Optional Extension Element - found in all resources. | ||
Cardinality | 0..1 | ||
Type | Extension(CodeableConcept) | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: ele-1 | ||
Constraints |
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Mappings |
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ReferralRequest.modifierExtension | |||
Short | Extensions that cannot be ignored | ||
Definition | May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Modifier | True | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Mappings |
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ReferralRequest.identifier | |||
Short | Business identifier | ||
Definition | Business identifier that uniquely identifies the referral/care transfer request instance. | ||
Cardinality | 1..* | ||
Type | Identifier | ||
Summary | True | ||
Mappings |
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ReferralRequest.identifier.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
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ReferralRequest.identifier.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
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ReferralRequest.identifier.use | |||
Short | usual | official | temp | secondary (If known) | ||
Definition | The purpose of this identifier. | ||
Cardinality | 0..1 | ||
Type | code | ||
Binding | Identifies the purpose for this identifier, if known . | ||
Modifier | True | ||
Summary | True | ||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||
Comments | This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||
Mappings |
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ReferralRequest.identifier.type | |||
Short | Description of identifier | ||
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||
Summary | True | ||
Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||
Mappings |
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ReferralRequest.identifier.system | |||
Short | The namespace for the identifier value | ||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||
Cardinality | 1..1 | ||
Type | uri | ||
Summary | True | ||
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||
Examples | Generalhttp://www.acme.com/identifiers/patient | ||
Mappings |
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ReferralRequest.identifier.value | |||
Short | The value that is unique | ||
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||
Cardinality | 1..1 | ||
Type | string | ||
Summary | True | ||
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. | ||
Examples | General123456 | ||
Mappings |
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ReferralRequest.identifier.period | |||
Short | Time period when id is/was valid for use | ||
Definition | Time period during which identifier is/was valid for use. | ||
Cardinality | 0..1 | ||
Type | Period | ||
Summary | True | ||
Mappings |
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ReferralRequest.identifier.assigner | |||
Short | Organization that issued id (may be just text) | ||
Definition | Organization that issued/manages the identifier. | ||
Cardinality | 0..1 | ||
Type | Reference(Organization) | ||
Summary | True | ||
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. | ||
Mappings |
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ReferralRequest.definition | |||
Short | Instantiates protocol or definition | ||
Definition | A protocol, guideline, orderset or other definition that is adhered to in whole or in part by this request. | ||
Cardinality | 0..* | ||
Type | Reference(ActivityDefinition | PlanDefinition) | ||
Summary | True | ||
Mappings |
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ReferralRequest.basedOn | |||
Short | Indicates any plans or prior referrals that this referral is intended to fulfill | ||
Definition | Indicates any plans, proposals or orders that this request is intended to satisfy - in whole or in part. | ||
Cardinality | 0..* | ||
Type | Reference(CareConnect-GPC-ReferralRequest-1 | CareConnect-CarePlan-1 | CareConnect-GPC-ProcedureRequest-1) | ||
Summary | True | ||
Alias | fulfills | ||
ReferralRequest.replaces | |||
Short | Request(s) replaced by this request | ||
Definition | Completed or terminated request(s) whose function is taken by this new request. | ||
Cardinality | 0..* | ||
Type | Reference(CareConnect-GPC-ReferralRequest-1) | ||
Summary | True | ||
Alias | supersedes, prior, renewed order | ||
Requirements | Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests. | ||
Comments | The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing. | ||
Mappings |
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ReferralRequest.groupIdentifier | |||
Short | Composite request this is part of | ||
Definition | The business identifier of the logical "grouping" request/order that this referral is a part of. | ||
Cardinality | 0..1 | ||
Type | Identifier | ||
Summary | True | ||
Alias | grouperId, requisition | ||
Requirements | Allows multiple orders to be collected as part of a single requisition. | ||
ReferralRequest.groupIdentifier.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
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ReferralRequest.groupIdentifier.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
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ReferralRequest.groupIdentifier.use | |||
Short | usual | official | temp | secondary (If known) | ||
Definition | The purpose of this identifier. | ||
Cardinality | 0..1 | ||
Type | code | ||
Binding | Identifies the purpose for this identifier, if known . | ||
Modifier | True | ||
Summary | True | ||
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||
Comments | This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||
Mappings |
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ReferralRequest.groupIdentifier.type | |||
Short | Description of identifier | ||
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||
Summary | True | ||
Requirements | Allows users to make use of identifiers when the identifier system is not known. | ||
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||
Mappings |
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ReferralRequest.groupIdentifier.system | |||
Short | The namespace for the identifier value | ||
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||
Cardinality | 0..1 | ||
Type | uri | ||
Summary | True | ||
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||
Examples | Generalhttp://www.acme.com/identifiers/patient | ||
Mappings |
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ReferralRequest.groupIdentifier.value | |||
Short | The value that is unique | ||
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. | ||
Cardinality | 0..1 | ||
Type | string | ||
Summary | True | ||
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. | ||
Examples | General123456 | ||
Mappings |
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ReferralRequest.groupIdentifier.period | |||
Short | Time period when id is/was valid for use | ||
Definition | Time period during which identifier is/was valid for use. | ||
Cardinality | 0..1 | ||
Type | Period | ||
Summary | True | ||
Mappings |
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ReferralRequest.groupIdentifier.assigner | |||
Short | Organization that issued id (may be just text) | ||
Definition | Organization that issued/manages the identifier. | ||
Cardinality | 0..1 | ||
Type | Reference(CareConnect-GPC-Organization-1) | ||
Summary | True | ||
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. | ||
Mappings |
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ReferralRequest.status | |||
Short | draft | active | suspended | cancelled | completed | entered-in-error | unknown | ||
Definition | The status of the authorization/intention reflected by the referral request record. | ||
Cardinality | 1..1 | ||
Type | code | ||
Binding | The status of the referral. | ||
Modifier | True | ||
Summary | True | ||
Requirements | Workflow status is handled by the Task resource. | ||
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. | ||
Auto Value | unknown | ||
Mappings |
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ReferralRequest.intent | |||
Short | proposal | plan | order | ||
Definition | Distinguishes the "level" of authorization/demand implicit in this request. | ||
Cardinality | 1..1 | ||
Type | code | ||
Binding | Codes identifying the stage lifecycle stage of a request | ||
Modifier | True | ||
Summary | True | ||
Alias | category | ||
Requirements | The same resource structure is used when capturing proposals/recommendations, plans and actual requests. | ||
Auto Value | order | ||
Mappings |
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ReferralRequest.type | |||
Short | Referral/Transition of care request type | ||
Definition | An indication of the type of referral (or where applicable the type of transfer of care) request. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | Codes for types of referral; e.g. consult, transfer, temporary transfer. | ||
Summary | True | ||
Mappings |
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ReferralRequest.priority | |||
Short | Urgency of referral / transfer of care request | ||
Definition | An indication of the urgency of referral (or where applicable the type of transfer of care) request. | ||
Cardinality | 0..1 | ||
Type | code | ||
Binding | Codes indicating the relative priority of the referral. | ||
Summary | True | ||
Mappings |
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ReferralRequest.serviceRequested | |||
Short | Actions requested as part of the referral | ||
Definition | The service(s) that is/are requested to be provided to the patient. For example: cardiac pacemaker insertion. | ||
Cardinality | 0..* | ||
Type | CodeableConcept | ||
Binding | Codes indicating the types of services that might be requested as part of a referral. | ||
Summary | True | ||
Mappings |
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ReferralRequest.subject | |||
Short | A reference to the patient who is the subject of the referral | ||
Definition | The patient who is the subject of a referral or transfer of care request. | ||
Cardinality | 1..1 | ||
Type | Reference(CareConnect-GPC-Patient-1) | ||
Summary | True | ||
Comments | Referral of family, group or community is to be catered for by profiles. | ||
Mappings |
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ReferralRequest.context | |||
Short | The consultation within which the referral was recorded | ||
Definition | The encounter at which the request for referral or transfer of care is initiated. | ||
Cardinality | 0..1 | ||
Type | Reference(CareConnect-EpisodeOfCare-1 | CareConnect-GPC-Encounter-1) | ||
Must Support | True | ||
Summary | True | ||
Alias | encounter | ||
Mappings |
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ReferralRequest.occurrence[x] | |||
Short | When the service(s) requested in the referral should occur | ||
Definition | The period of time within which the services identified in the referral/transfer of care is specified or required to occur. | ||
Cardinality | 0..1 | ||
Type | dateTime, Period | ||
Summary | True | ||
Alias | timing | ||
Requirements | Use cases: (1) to indicate that the requested service is not to happen before a specified date, and saving the start date in Period.start; (2) to indicate that the requested service must happen before a specified date, and saving the end date in Period.end; (3) to indicate that the requested service must happen during the specified dates ("start" and "end" values). | ||
Comments | When the occurrenceDateTime is used, then it is indicating that the requested service must happen before the specified date. | ||
Mappings |
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ReferralRequest.authoredOn | |||
Short | The user entered date for the referral | ||
Definition | Date/DateTime of creation for draft requests and date of activation for active requests. | ||
Cardinality | 0..1 | ||
Type | dateTime | ||
Must Support | True | ||
Summary | True | ||
Alias | createdOn | ||
Mappings |
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ReferralRequest.requester | |||
Short | Who has administered the referral request | ||
Definition | The individual who initiated the request and has responsibility for its activation. | ||
Cardinality | 0..1 | ||
Type | BackboneElement | ||
Must Support | True | ||
Summary | True | ||
Alias | author | ||
Constraints |
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Mappings |
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ReferralRequest.requester.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
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ReferralRequest.requester.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Mappings |
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ReferralRequest.requester.modifierExtension | |||
Short | Extensions that cannot be ignored | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Modifier | True | ||
Summary | True | ||
Alias | extensions, user content, modifiers | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Mappings |
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ReferralRequest.requester.agent | |||
Short | Individual making the request | ||
Definition | The device, practitioner, etc. who initiated the request. | ||
Cardinality | 1..1 | ||
Type | Reference(Device | CareConnect-RelatedPerson-1 | CareConnect-GPC-Organization-1 | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1) | ||
Summary | True | ||
Mappings |
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ReferralRequest.requester.onBehalfOf | |||
Short | Organization agent is acting for | ||
Definition | The organization the device or practitioner was acting on behalf of. | ||
Cardinality | 0..1 | ||
Type | Reference(CareConnect-GPC-Organization-1) | ||
Summary | True | ||
Requirements | Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request. | ||
Conditions | The cardinality or value of this element may be affected by these constraints: rfr-1 | ||
Mappings |
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ReferralRequest.specialty | |||
Short | The clinical specialty (discipline) that the referral is requested for | ||
Definition | Indication of the clinical domain or discipline to which the referral or transfer of care request is sent. For example: Cardiology Gastroenterology Diabetology. | ||
Cardinality | 0..1 | ||
Type | CodeableConcept | ||
Binding | Codes indicating the types of capability the referred to service provider must have. | ||
Mappings |
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ReferralRequest.recipient | |||
Short | Receiver of referral / transfer of care request | ||
Definition | The healthcare provider(s) or provider organization(s) who/which is to receive the referral/transfer of care request. | ||
Cardinality | 0..* | ||
Type | Reference(CareConnect-HealthcareService-1 | CareConnect-GPC-Organization-1 | CareConnect-GPC-Practitioner-1) | ||
Must Support | True | ||
Summary | True | ||
Comments | There will be a primary receiver. But the request can be received by any number of "copied to" providers or organizations. | ||
Mappings |
| ||
ReferralRequest.reasonCode | |||
Short | Reason for referral / transfer of care request | ||
Definition | Description of clinical condition indicating why referral/transfer of care is requested. For example: Pathological Anomalies, Disabled (physical or mental), Behavioral Management. | ||
Cardinality | 0..* | ||
Type | CodeableConcept | ||
Binding | Codes indicating why the referral is being requested. | ||
Must Support | True | ||
Summary | True | ||
Mappings |
| ||
ReferralRequest.reasonReference | |||
Short | The problem(s) linked to the referral | ||
Definition | Indicates another resource whose existence justifies this request. | ||
Cardinality | 0..* | ||
Type | Reference(CareConnect-GPC-Condition-1 | CareConnect-GPC-Observation-1 | CareConnect-GPC-ProblemHeader-Condition-1) | ||
Summary | True | ||
Mappings |
| ||
ReferralRequest.description | |||
Short | The free text description for the referral | ||
Definition | The reason element gives a short description of why the referral is being made, the description expands on this to support a more complete clinical summary. | ||
Cardinality | 0..1 | ||
Type | string | ||
Must Support | True | ||
ReferralRequest.supportingInfo | |||
Short | The referral letter(s) and any other supporting documents or linked detail with relates to another resource which is not specifically defined to another referralRequest element | ||
Definition | Any additional (administrative, financial or clinical) information required to support request for referral or transfer of care. For example: Presenting problems/chief complaints Medical History Family History Alerts Allergy/Intolerance and Adverse Reactions Medications Observations/Assessments (may include cognitive and fundtional assessments) Diagnostic Reports Care Plan. | ||
Cardinality | 0..* | ||
Type | Reference(Resource) | ||
Must Support | True | ||
ReferralRequest.note | |||
Short | Any additional information recorded against the referral | ||
Definition | This could include additional categorisation of the referral or notes recorded post referral such as details of progress or outcomes. | ||
Cardinality | 0..* | ||
Type | Annotation | ||
Must Support | True | ||
ReferralRequest.note.id | |||
Short | xml:id (or equivalent in JSON) | ||
Definition | unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||
Cardinality | 0..1 | ||
Type | string | ||
Mappings |
| ||
ReferralRequest.note.extension | |||
Short | Additional Content defined by implementations | ||
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||
Cardinality | 0..* | ||
Type | Extension | ||
Alias | extensions, user content | ||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||
Slicing | Unordered, Open, by url(Value) Extensions are always sliced by (at least) url | ||
Mappings |
| ||
ReferralRequest.note.author[x] | |||
Short | Individual responsible for the annotation | ||
Definition | The individual responsible for making the annotation. | ||
Cardinality | 0..1 | ||
Type | Reference(CareConnect-RelatedPerson-1 | CareConnect-GPC-Patient-1 | CareConnect-GPC-Practitioner-1), string | ||
Summary | True | ||
Mappings |
| ||
ReferralRequest.note.time | |||
Short | When the annotation was made | ||
Definition | Indicates when this particular annotation was made. | ||
Cardinality | 0..1 | ||
Type | dateTime | ||
Summary | True | ||
Mappings |
| ||
ReferralRequest.note.text | |||
Short | The annotation - text content | ||
Definition | The text of the annotation. | ||
Cardinality | 1..1 | ||
Type | string | ||
Mappings |
| ||
ReferralRequest.relevantHistory | |||
Short | Key events in history of request | ||
Definition | Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the resource. | ||
Cardinality | 0..* | ||
Type | Reference(Provenance) | ||
Alias | eventHistory | ||
Comments | This element does not point to the Provenance associated with the current version of the resource - as it would be created after this version existed. The Provenance for the current version can be retrieved with a _revinclude. | ||
Mappings |
|
Element | Use | CareConnect (STU3) | UK Core (R4) |
---|---|---|---|
id | |||
meta.versionId | |||
meta.lastUpdated | |||
meta.profile | |||
meta.security | |||
meta.tag | |||
identifier | |||
definition | |||
basedOn | |||
replaces | |||
groupIdentifier | |||
status | |||
intent | |||
type | |||
priority | |||
serviceRequested | |||
subject | |||
context | |||
occurence[x] | |||
authoredOn | |||
requester | |||
specialty | |||
recipient | |||
reasonCode | |||
description | |||
supportingInfo | |||
note | |||
relevantHistory | |||
extension(ReferralRequestMethod) |
id
Usage
Optional
Guidance
The id
is the logical identifier for the CareConnect-GPC-ReferralRequest-1
profile.
Example
<id value="5837b927-e939-4aa1-8b19-5442b8a567ba" />
meta.versionId
Usage
Optional
Guidance
The population of the meta.versionId
element could be useful if sending an adendum of something previously sent to help the consumer (receiver) in understanding there is a "newer" version.
Example
<meta> <versionId value="1" /> </meta>
meta.lastUpdated
Usage
Optional
Guidance
The meta.lastUpdated
element could be useful alongside the meta.versionId
element could be useful if sending an adendum of something previously sent to help the consumer (receiver) in understanding there is a "newer" version.
Example
<meta> <lastUpdated value="2022-10-28T08:06:00+00:00" /> </meta>
meta.profile
Usage
Mandatory
Guidance
The meta.profile
contains a fixed value of the URL for the CareConnect-GPC-ReferralRequest-1
profile.
Example
<meta> <profile value="https://fhir.nhs.uk/STU3/StructureDefinition/CareConnect-GPC-ReferralRequest-1" /> </meta>
meta.security
Usage
Optional
Guidance
The security label(s) applicable to the resource.
See Resources not to be disclosed to a patient for more details on how to populate the element.
Example
<meta> <security> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="NOPAT"/> <display value="no disclosure to patient, family or caregivers without attending provider's authorization"/> </security> </meta>
meta.tag
Usage
Optional
Guidance
A use-case for the meta.tag
element within GP Connect has not been defined.
Example
<meta> <tag> <coding> <system value="http://hl7.org/fhir/common-tags" /> <code value="actionable" /> <display value="Actionable" /> </coding> </tag> </meta>
identifier
Usage
Optional
Guidance
The identifier
MUST be populated with a globally unique and persistent identifier (that is, it doesn’t change between requests and therefore stored with the source data). This MUST be scoped by a provider specific namespace for the identifier.
Where consuming systems are integrating data from this resource to their local system, they MUST also persist this identifier at the same time.
If the referral was made via the e-Referral Service and a Unique Booking Reference Number (UBRN) exists for the referral, then it MUST be included as an identifier. The system identifier for this is https://fhir.nhs.uk/Id/ubr-number
.
Example
<identifier> <system value="https://foo.bar/id/referral-request" /> <value value="fef26348-ccd1-440b-940e-ba1ec058cf21" /> </identifier>
definition
Usage
Optional
Guidance
A use-case for the definition
element within GP Connect has not been defined.
Example
<definition> <reference value="plan-definition--00192ast" /> </definition>
basedOn
Usage
Optional
Guidance
Indicates any plans or prior referrals that this referral is intended to fulfill.
Example
<basedOn> <reference value="careplan--procedure-request--referral-request--00123f72" /> </basedOn>
replaces
Usage
Optional
Guidance
A use-case for the replaces
element within GP Connect has not been defined as terminated referrals are not in scope (thus cannot be referenced).
Any association to a prior, completed referral can be made via the basedOn
element.
Example
<replaces> <reference value="careplan--procedure-request--referral-request--0071dj" /> </replaces>
groupIdentifier
Usage
Optional
Guidance
A use-case for the groupIdentifier
element within GP Connect has not been defined.
Example
<identifier> <system value="https://foo.bar/id/referral-request/group" /> <value value="ea01541c-dbe0-4b23-b492-b7d5f2c45d3a" /> </identifier>
status
Usage
Mandatory
Guidance
A default value of unknown
SHOULD be used for open or complete referrals as generally the status of referrals is not consistently maintained in a GP patient record. A status of cancelled
MAY be used where the GP System has directly cancelled a referral, for example cancelled via eRS. Referrals entered in error
MUST NOT be included.
Example
<status value="unknown" />
intent
Usage
Mandatory
Guidance
The status
element is a mandatory one within FHIR and while it can be populated with any value from the available code system, it is expected that must use-cases within GP Connect will be order
.
Example
<status value="order" />
type
Usage
Optional
Guidance
A use-case for the type
element has not been defined for GP Connect; however, it is expected that reasonCode
element can be used to represent a referral code using SNOMED CT.
Example
<type> <coding> <system value="http://snomed.info/sct" /> <code value="397721007" /> <display value="Referral by Accident and Emergency (procedure)" /> <snomedCT> <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid" /> <extension> <valueId value="397721007" /> <descriptionId value="397721007" /> <descriptionDisplay value="Referral by Accident and Emergency (procedure)" /> </extesion> </snomedCT> </coding> <text value="Referral by Accident and Emergency (procedure)" /> </type>
priority
Usage
Optional
Guidance
A mapping is applied to the priority codes to align it to the e-Referral Service priority types. This MUST be populated where the source system has a referral priority which matches the e-Referral Service priority codes or can be mapped to those priority codes. If there is a priority code for the referral but it is incompatible with the e-Referral Service priorities, this element MUST be excluded and the priority MUST be supplied in the note
element.
Example
<priority value="stat" />
serviceRequested
Usage
Optional
Guidance
This MUST NOT be populated with the source system’s main code for the referral, which MUST be returned in the reasonCode
element. This MAY be populated if the GP clinical system also holds a distinct entry for the type of service requested.
Example
<serviceRequested> <coding> <system value="http://snomed.info/sct" /> <code value="394597005" /> <display value="Histopathology" /> <snomedCT> <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid" /> <extension> <valueId value="394597005" /> <descriptionId value="394597005" /> <descriptionDisplay value="Histopathology" /> </extesion> </snomedCT> </coding> <text value="Histopathology" /> </serviceRequested>
subject
Usage
Mandatory
Guidance
The subject
element will contain a reference to the Patient that the ReferralRequest
is regarding. This can either be as a reference within the payload, or using the reference.identifier
.
Example
<subject> <extension> <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1" /> <valueCodeableConcept> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1" /> <code value="01" /> <display value="Number present and verified" /> </coding> <!-- text optional as already stipulated within the codeable concept --> <text value="Number present and verified" /> </valueCodeableConcept> </extension> <system value="https://fhir.nhs.uk/Id/nhs-number" /> <value value="4857773456" /> </subject>
context
Usage
Required
Guidance
A reference to the Consultation (Encounter or Episode of Care) within which the referral was recorded.
Example
<context> <reference value="encounter-933d0c70-3bd9-400b-82b5-d717ec593824" /> </context>
occurrence[x]
Usage
Optional
Guidance
A use-case for the occurrence[x]
element within GP Connect has not been defined.
Example
<occurrenceDateTime value="2022-12-13T13:33:00Z" />
requester.agent
Usage
Required
Guidance
The preferred agent is the practitioner responsible for the decision to refer the patient. If the referral is not attributed to a practitioner, then any of the other resource options MAY be used as most appropriate. If the referral does not clearly identify responsibility for the referral decision or action, this MUST be the user who recorded the referral.
Example
<requester> <agent> <identifier> <system value="https://fhir.hl7.org.uk/Id/gmc-number" /> <value value="000000000" /> <display value="Test GP" /> </identifier> </agent> </requester>
requester.onBehalfOf
Usage
Required
Guidance
This MUST be populated if the requester.agent
is a practitioner and the Organization
associated with the referenced Practitioner
is not the GP practice responsible for the referral. This element SHOULD be absent if the requester.agent
is not a practitioner. This element MAY be populated or absent where the GP practice responsible for the referral is the same organisation as associated with requester.agent
practitioner via the practitioner role.
Example
<requester> <onBehalfOf> <identifier> <system value="https://fhir.hl7.org.uk/Id/gmc-number" /> <value value="012340000" /> <display value="Test Practitioner" /> </identifier> </onBehalfOf> </requester>
specialty
Usage
Optional
Guidance
This MUST NOT be populated with the source system’s main code for the referral, which MUST be returned in the reasonCode
element. This MAY be populated if the GP clinical system holds a distinct entry for the clinical or practitioner specialty requested by the referral.
Example
<specialty> <coding> <system value="http://hl7.org/fhir/practitioner-specialty" /> <code value="cardio" /> <display value="Cardiologist" /> <snomedCT> <url value="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-coding-sctdescid" /> <extension> <valueId value="cardio" /> <descriptionId value="cardio" /> <descriptionDisplay value="Cardiologist" /> </extesion> </snomedCT> </coding> <text value="Cardiologist" /> </specialty>
recipient
Usage
Required
Guidance
The recipient
element can be used to indicate which practitioner and / or organisation the patient has been referred to, providing that it has been recorded in a suitable coded format.
If the referral recipient details are in a form which cannot be returned as a referenced resource, the details should be populated in the note
element as key value pairs.
Example
<recipient> <reference> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code" /> <value value="Q72" /> <display value="NHS ENGLAND NORTH EAST AND YORKSHIRE (YORKSHIRE AND HUMBER) (Q72)" /> </identifier> </reference> </recipient>
OR
<note> <author> <reference value="practitioner-948392" /> </author> <time value="2022-10-13T16:59:00Z" /> <text> Practitioner: Dr Make-you-well Organisation: An example organisation </text> </note>
reasonCode
Usage
Required
Guidance
The reasonCode
element can be populated with the source system’s main coded entry for the referral.
Additional, coded or text entries which are clearly captured as reasons for referral may also be included.
Example
<reasonCode> <coding> <system value="http://snomed.info/sct" /> <code value="195967001" /> <display value="Asthma (disorder)" /> </coding> </reasonCode>
reasonReference
Usage
Optional
Guidance
A referral may have a linked problem which represents the reason for the referral.
Where the inforamtion is available, referencing the problem that teh referral is regarding may be useful.
Example
<reasonReference> <reference value="problem-header-condition--00f39ds" /> </reasonReference>
description
Usage
Required
Guidance
The description
element can be populated with the free text description associated with the referral.
Example
<description value="Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut rutrum." />
supportingInfo
Usage
Required
Guidance
Reference to the referral letter(s) and any other supporting documents or resources which are not covered by other more specific elements, for instance this could include reference to linked observations or test results.
This does not apply to a linked problem. The problem MUST be included in the bundle and reference to the referralRequest
. The referralRequest
MUST NOT reference to the problem.
Example
<supportingInfo> <reference value="observation-001sdk345" /> </supportingInfo>
note
Usage
Required
Guidance
Any additional information recorded against the referral which is not accommodated by other elements. This could include additional categorisation of the referral or notes recorded against the referral after it has been made such as details of progress or outcomes.
Example
<note> <author> <reference value="practitioner-948392" /> </author> <time value="2022-10-13T16:59:00Z" /> <text> Free text... R4 of the FHIR standard supports GitHub Flavoured Markdown (GFM). </text> </note>
relevantHistory
Usage
Optional
Guidance
A use-case for the relevantHistory
element within GP Connect has not been defined.
Example
<reasonReference> <reference value="provenance--00y1pa2" /> </reasonReference>
extension(ReferralRequestMethod)
Usage
Optional
Guidance
The method used to send or receive a Referral Request.
Example
<extension url="https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-ReferralRequestMethod-1"> <valueCodeableConcept> <coding> <system value="https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-ReferralRequestMethod-1" /> <code value="2" /> <display value="Phone" /> </coding> </valueCodeableConcept> </extension>