This page is part of the Quality Improvement Core Framework (v3.1.0: STU 3) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

ReferralRequest example

Formats: Narrative, XML, JSON, Turtle

Raw xml

<ReferralRequest xmlns="http://hl7.org/fhir">
  <id value="example"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-referralrequest"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example</p><p><b>meta</b>: </p><p><b>status</b>: cancelled</p><p><b>intent</b>: order</p><p><b>type</b>: Referral for procedure <span style="background: LightGoldenRodYellow">(Details : {SNOMED CT code '700274009' = 'Referral for procedure', given as 'Referral for procedure'})</span></p><p><b>priority</b>: routine</p><p><b>serviceRequested</b>: Myringotomy and insertion of short-term tympanic ventilation tube (procedure) <span style="background: LightGoldenRodYellow">(Details : {SNOMED CT code '172676009' = 'Myringotomy and insertion of short-term grommet', given as 'Myringotomy and insertion of short-term tympanic ventilation tube (procedure)'})</span></p><p><b>subject</b>: <a href="Patient-example.html">Generated Summary: id: example; Medical record number = 12345 (USUAL); active; Peter James Chalmers (OFFICIAL), Jim Chalmers , Peter James Windsor (MAIDEN); -unknown-(HOME), ph: (03) 5555 6473(WORK), ph: (03) 3410 5613(MOBILE), ph: (03) 5555 8834(OLD); gender: male; birthDate: 25/12/1974; </a></p><p><b>context</b>: <a href="Encounter-example.html">Generated Summary: id: example; status: in-progress; <span title="{http://hl7.org/fhir/v3/ActCode IMP}">inpatient encounter</span></a></p><p><b>occurrence</b>: 13/02/2014</p><p><b>authoredOn</b>: 14/02/2014</p><p><b>specialty</b>: Pediatric otolaryngology <span style="background: LightGoldenRodYellow">(Details : {SNOMED CT code '417887005' = 'Pediatric otolaryngology', given as 'Pediatric otolaryngology'})</span></p><p><b>reasonCode</b>: Otitis media <span style="background: LightGoldenRodYellow">(Details : {SNOMED CT code '65363002' = 'Otitis media', given as 'Otitis media'})</span></p></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/referralrequest-reasonRefused">
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="609589008"/>
        <display value="Refused by parents of subject"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <status value="cancelled"/>
  <intent value="order"/>
  <type>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="700274009"/>
      <display value="Referral for procedure"/>
    </coding>
  </type>
  <priority value="routine"/>
  <serviceRequested>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="172676009"/>
      <display
               value="Myringotomy and insertion of short-term tympanic ventilation tube (procedure)"/>
    </coding>
  </serviceRequested>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <context>
    <reference value="Encounter/example"/>
  </context>
  <occurrenceDateTime value="2014-02-13"/>
  <authoredOn value="2014-02-14"/>
<!-- <requester> -->
<!-- <agent> -->
<!-- <reference value="Practitioner/example"/> -->
<!-- </agent> -->
<!-- </requester> -->
  <specialty>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="417887005"/>
      <display value="Pediatric otolaryngology"/>
    </coding>
  </specialty>
<!-- <recipient> -->
<!-- <reference value="Practitioner/example"/> -->
<!-- </recipient> -->
  <reasonCode>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="65363002"/>
      <display value="Otitis media"/>
    </coding>
  </reasonCode>
</ReferralRequest>