FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R3 R2

Patient Care Work GroupMaturity Level: 1 Trial UseCompartments: Patient, Practitioner

Detailed Descriptions for the elements in the ReferralRequest resource.

ReferralRequest
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.

Control1..1
Alternate NamesReferralRequest TransferOfCare Request
ReferralRequest.identifier
Definition

Business identifier that uniquely identifies the referral/care transfer request instance.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
ReferralRequest.definition
Definition

A protocol, guideline, orderset or other definition that is adhered to in whole or in part by this request.

Control0..*
TypeReference(ActivityDefinition | PlanDefinition)
Summarytrue
ReferralRequest.basedOn
Definition

Indicates any plans, proposals or orders that this request is intended to satisfy - in whole or in part.

Control0..*
TypeReference(ReferralRequest | CarePlan | ProcedureRequest)
Alternate Namesfulfills
Summarytrue
ReferralRequest.replaces
Definition

Completed or terminated request(s) whose function is taken by this new request.

Control0..*
TypeReference(ReferralRequest)
Requirements

Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

Alternate Namessupersedes; prior; renewed order
Summarytrue
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.

ReferralRequest.groupIdentifier
Definition

The business identifier of the logical "grouping" request/order that this referral is a part of.

Control0..1
TypeIdentifier
Requirements

Allows multiple orders to be collected as part of a single requisition.

Alternate NamesgrouperId; requisition
Summarytrue
ReferralRequest.status
Definition

The status of the authorization/intention reflected by the referral request record.

Control1..1
Terminology BindingRequestStatus (Required)
Typecode
Is Modifiertrue
Requirements

Workflow status is handled by the Task resource.

Summarytrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

ReferralRequest.intent
Definition

Distinguishes the "level" of authorization/demand implicit in this request.

Control1..1
Terminology BindingRequestIntent (Required)
Typecode
Is Modifiertrue
Requirements

The same resource structure is used when capturing proposals/recommendations, plans and actual requests.

Alternate Namescategory
Summarytrue
ReferralRequest.type
Definition

An indication of the type of referral (or where applicable the type of transfer of care) request.

Control0..1
Terminology BindingSNOMED CT Patient Referral (Example)
TypeCodeableConcept
Summarytrue
ReferralRequest.priority
Definition

An indication of the urgency of referral (or where applicable the type of transfer of care) request.

Control0..1
Terminology BindingRequestPriority (Required)
Typecode
Summarytrue
ReferralRequest.serviceRequested
Definition

The service(s) that is/are requested to be provided to the patient. For example: cardiac pacemaker insertion.

Control0..*
Terminology BindingPractice Setting Code Value Set (Example)
TypeCodeableConcept
Summarytrue
ReferralRequest.subject
Definition

The patient who is the subject of a referral or transfer of care request.

Control1..1
TypeReference(Patient | Group)
Summarytrue
Comments

Referral of family, group or community is to be catered for by profiles.

ReferralRequest.context
Definition

The encounter at which the request for referral or transfer of care is initiated.

Control0..1
TypeReference(Encounter | EpisodeOfCare)
Alternate Namesencounter
Summarytrue
ReferralRequest.occurrence[x]
Definition

The period of time within which the services identified in the referral/transfer of care is specified or required to occur.

Control0..1
TypedateTime|Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
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).

Alternate Namestiming
Summarytrue
Comments

When the occurrenceDateTime is used, then it is indicating that the requested service must happen before the specified date.

ReferralRequest.authoredOn
Definition

Date/DateTime of creation for draft requests and date of activation for active requests.

Control0..1
TypedateTime
Alternate NamescreatedOn
Summarytrue
ReferralRequest.requester
Definition

The individual who initiated the request and has responsibility for its activation.

Control0..1
Alternate Namesauthor
Summarytrue
InvariantsDefined on this element
rfr-1: onBehalfOf can only be specified if agent is practitioner or device (expression : (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not(), xpath: contains(f:agent/f:reference/@value, '/Practitioner/') or contains(f:agent/f:reference/@value, '/Device/') or not(exists(f:onBehalfOf)))
ReferralRequest.requester.agent
Definition

The device, practitioner, etc. who initiated the request.

Control1..1
TypeReference(Practitioner | Organization | Patient | RelatedPerson | Device)
Summarytrue
ReferralRequest.requester.onBehalfOf
Definition

The organization the device or practitioner was acting on behalf of.

Control0..1
TypeReference(Organization)
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.

Summarytrue
InvariantsAffect this element
rfr-1: onBehalfOf can only be specified if agent is practitioner or device (expression : (agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not(), xpath: contains(f:agent/f:reference/@value, '/Practitioner/') or contains(f:agent/f:reference/@value, '/Device/') or not(exists(f:onBehalfOf)))
ReferralRequest.specialty
Definition

Indication of the clinical domain or discipline to which the referral or transfer of care request is sent. For example: Cardiology Gastroenterology Diabetology.

Control0..1
Terminology BindingPractitionerSpecialty (Example)
TypeCodeableConcept
ReferralRequest.recipient
Definition

The healthcare provider(s) or provider organization(s) who/which is to receive the referral/transfer of care request.

Control0..*
TypeReference(Practitioner | Organization | HealthcareService)
Summarytrue
Comments

There will be a primary receiver. But the request can be received by any number of "copied to" providers or organizations.

ReferralRequest.reasonCode
Definition

Description of clinical condition indicating why referral/transfer of care is requested. For example: Pathological Anomalies, Disabled (physical or mental), Behavioral Management.

Control0..*
Terminology BindingSNOMED CT Clinical Findings (Example)
TypeCodeableConcept
Summarytrue
ReferralRequest.reasonReference
Definition

Indicates another resource whose existence justifies this request.

Control0..*
TypeReference(Condition | Observation)
Summarytrue
ReferralRequest.description
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.

Control0..1
Typestring
ReferralRequest.supportingInfo
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.

Control0..*
TypeReference(Any)
ReferralRequest.note
Definition

Comments made about the referral request by any of the participants.

Control0..*
TypeAnnotation
ReferralRequest.relevantHistory
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.

Control0..*
TypeReference(Provenance)
Alternate NameseventHistory
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.