DRAFT - The specification is currently in development and subject to significant change. It is not ready for limited roll-out or production level use.

Participants in eReferral eConsult Information Exchange


During the service lifecycle, information is contributed to the Service Record by different parties participating in the process. By different People, Organizations and Systems.


People / Organizations

Party Description
Requester HCP A Health Care Provider (HCP) or their delegate (e.g. medical office assistant), or other service provider that initiates and sends the service request. For eReferrals/eConsults, this is typically the primary care provider.
Case Assigner An individual, organization, or automated process responsible for associating a request with a Performer HCP. Depending on the model employed, this could be a distinct role with additional responsibilities or performed by either the Requester HCP or Performer HCP.
Performer HCP A Health Care Provider (HCP) or delegate, (e.g. medical office assistant), or other service provider that receives the service request and performs the requested services.

Systems

The following systems commonly support end user workflows that support the service lifecycle and contribute to a patient's Service Record in one or more System Roles.

System Description
Referral Management System (RMS) A specialized system that provides users with the functionality to collect, maintain, manage and disseminate information between participants in eReferral or eConsult workflows throughout the service lifecycle.

A key function of an RMS is to generate and store a Service Record to support record keeping and communication throughout the service lifecycle.
Point of Service System (POS) A system used in clinical settings to view and/or manage patient health information and health records. POS systems are an important source of supporting clinical information for an eReferral or eConsult. POS Systems participating in eReferral and eConsult include but are not limited to hospital information systems (HIS), electronic medical/health record (EMR/EHR) systems and provincial/regional EHR viewers.

POS systems participating in eReferral / eConsult may provide the ability to initiate a request, receive updates as the request progresses and/or to receive a copy of the Service Record to support clinician workflow or recordkeeping requirements without providing other referral management functionality of a specialized RMS.

Roles of Systems

System Description
Source System A POS or RMS that is used by a Requester HCP to initiate a service request and to receive and access information about the request's status with related information and appointments.
Target System A POS or RMS that is used by a Performer HCP to receive and process service requests.
Central System A system (typically an RMS) that is used by a Case Assigner to receive, triage and assign service requests to Performer HCPs to be completed.

Some business and deployment models (e.g.: Central Access and Triage) treat the Central System as the definitive source of the Service Record throughout the service lifecycle to support the use of Source System and/or Target System with limited RMS functionality.
Connected System A system that receives event based notifications containing Service Record information from an RMS without contributing content to or progressing the state of the record.

Information Contributed to the Service Record

System Primary Users Content Provided
Source System Requester HCP - Patient Demographic and Identifying Info
- Referring Practitioner Identifying Info
- Requested Service
- Referral Reason
- Supporting Documentation
Central System Case Assigner - Service Provider Identifying Info
Target System Performer HCP - Referral Status
- Appointment Info
- Outcome(s)

Information contributed to the record by the parties participating in eReferral/eConsult information exchange may originate in other systems integrated with some or all of the participating systems. This information exchange is beyond the scope of this guide, but where shared reference systems exist, references in messages may be used to look up information from the definitive source.

System Description Relevant Content
Jurisdictional Registries Registry systems within a jurisdiction may provide a definitive source for information about people, organizations or services referenced in a referral request or record.

Relevant registries include: Client/Patient (CR), Provider (PR), Healthcare Service Directory (HSD)
CR: Patient Demographic and Identifying Info
PR: Requester HCP Identifying Info & Performer HCP Identifying Info
HSD: Requested Service & Service Provider Identifying Info
For implementation guidance on interactions with a Service directory, please refer to the pan-Canadian Care Service Directory (CA:CSD)
Jurisdictional EHR A jurisdiction's EHR may provide users of a POS or RMS with access to patient health information from other care settings that may be referenced in a referral. - Supporting Documentation in referral