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The exchange paradigms outlined within this Implementation Guide are designed to be applied to both eReferral and eConsult workflows across Canadian Jurisdictions. They therefore support workflows and integration patterns that vary across jurisdictions and care settings to address the requirements and constraints imposed by different clinical pathways and integration architectures.
System Maturity Levels
Systems participating in eReferral and eConsult may have different levels of maturity / capability.
| Level | Associated Capabilities |
|---|---|
| Level 1 (L1) | The ability for a Source System to send or Target System to receive an electronic referral request. |
| Level 2 (L2) | Level 1 abilities plus the ability to for a Target System to send or Source System to receive status updates to track processing of a request. |
| Level 3 (L3) | Level 1 and 2 abilities plus support for more advanced functions including: - sharing of appointment information - secure messaging between participants in the referral process - sharing of information with connected systems - support for single entry models |
Note:
- L3 capabilities may be implemented separately
- Most system procurements will require L3 support.
- To function in real-world environments, L2 and L3 systems SHOULD be designed to safely integrate with less mature systems.
Detailed Capabilities by System Level
| System Levels | Description |
|---|---|
| L1: Send, Receive, Revoke | Systems with Level 1 capabilities provide the minimum requirements for systems to participate in the exchange of an electronic referral request. |
| L1: Attaching Supporting Information | In eReferral and eConsult workflows a Service Request is typically accompanied by Supporting Information needed to support intake, triage or processing of a referral including pathway or destination specific referral forms, results of diagnostic tests, images, etc. |
| L2: Shared Workflow Status | Level 2 systems build upon the simple electronic exchange of referral information provided by Level 1 systems by: enabling a Target System to share the status of work performed in response to a Service Request received (eReferral or eConsult), and |
| L3: Appointments | Level 3 systems build upon status tracking capabilities of Level 2 systems by exchanging information about appointments that are scheduled as a result of an eReferral |
| L3: Communications | Secure communications between health care providers related to eReferral or eConsult are supported by messages that focus on the `Communication` resource.
The messaging supports both "general communications" and "requests for information". In practice, they are usually the latter and therefore should be treated as consequence events. |
| L3: Advanced Workflows | Where Single Entry Models are in use, a Service Record created on a Central System in response to request sent by a Requester HCP is processed by a Case Assigner who accepts the request, performs designated tasks, that result in the assignment of work to one or more Performer HCPs who may receive and process the request on different Target Systems. |
| L3: eReferral vs eConsult | The exchange paradigms outlined within this Implementation Guide can be applied to both eReferral and eConsult workflows but there are slight variations between workflow to be taken into consideration when using this specification. |