Basic Integration Patterns

CA:eReC Messaging is meant to provide implementable technical specifications in support of real-world architectures associated with a range of integration patterns supporting different Business Models. Two basic message integration patterns provide building blocks for real-world solutions.

Requester/Performer Point-to-Point Integration (P2P)

The Requester/Performer Integration provides a means to exchange information within a closed loop eReferral / eConsult process where the Requester HCP and the Performer HCP work in separate systems, each with a separate record of the service being requested and performed.

Information exchange is supported by technical actors that align closely with the role of the user performing actions in a system to trigger the information exchange. Each actor contributes information to a notional or actual Service Record as the work to initiate the request and perform the service advances. Each actor is considered the definitive source for the information within their scope.

Technical Actors, Systems and Users

A basic P2P integration between a Source System and Target System to manage a referral with the relevant actors is illustrated below.

Role of Technical Actors

• eReC Requester: As an integration component of the system used by the Requester HCP, the eReC Requester uses eReC FHIR Messages to send service requests to Performing HCPs or delegates along with information needed to successfully triage and perform the requested service, including:

  • Patient Demographic and Identifying Info
  • Referring Practitioner Identifying Info
  • Requested Service
  • Referral Reason
  • Supporting Documentation

• eReC Performer: As an integration component of the system used by the Performer HCP, the eReC Performer uses eReC FHIR Messages to communicate acceptance of the referral and to share information as the work progresses including:

  • Referral Status
  • Appointment Info
  • Outcomes

Informer/Recipient Integration

The Informer/Recepient Integration provides a means for a system used to create and/or manage referrals to share information with other systems used by parties that participate in or need to be informed about service being requested and/or their status.

Technical Actors, Systems and Users

An example of Informer/Recipient integration is illustrated below:

Role of Technical Actors

• eReC Informer: As an integration component of a system used to create, manage, fulfill or store a Service Record, the eReC Informer uses eReC FHIR messages to notify interested parties / systems when a new Service Record is created, when content is added or changes, and when its state changes.

• eReC Recipient: As an integration component of a system used by an interested party, the eReC Recipient uses eReC FHIR messages to recieve notifications with information to maintain a copy of the Service Record. eRec Recipients may be a component of POS system used by an HCP participating in the request process or at the patient's medical home, shared EHR accessed by patient or provider portals, etc.