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.

The workflow status of Business identifier that uniquely identifies the referral or referral/care transfer of care request. request instance.

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

Business identifier Indicates any plans, proposals or orders that uniquely identifies the referral/care transfer this request instance. is intended to satisfy - in whole or in part.

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

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

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.

Date/DateTime of creation for draft requests and date The business identifier of activation for active requests. the logical "grouping" request/order that this referral is a part of.

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

An indication The status of the type of referral (or where applicable authorization/intention reflected by the type of transfer of care) request. referral request record.

Workflow status is handled by the Task resource.

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

Distinguishes the "level" of referral type: - consultation; second opinion; third opinion - Assume management - Request for procedure(s) HL7 v2.8 Example - Table 0336: S = second opinion p = patient preference o = provider ordered w = work load. authorization/demand implicit in this request.

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

Indication An indication of the clinical domain or discipline to which the type of referral or (or where applicable the type of transfer of care request is sent. For example: Cardiology Gastroenterology Diabetology. care) request.

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

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

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

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

The healthcare provider or provider organization who/which initiated encounter at which the referral/transfer request for referral or transfer of care request. Can also be Patient (a self referral). is initiated.

The healthcare provider(s) or provider organization(s) who/which is to receive period of time within which the services identified in the referral/transfer of care request. is specified or required to occur.

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).

There will be a primary receiver. But When the request can be received by any number occurrenceDateTime is used, then it is indicating that the requested service must happen before the specified date.

Date/DateTime of "copied to" providers or organizations. creation for draft requests and date of activation for active requests.

The encounter at which individual who initiated the request and has responsibility for referral its activation.

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

Date/DateTime The organization the request for referral device or transfer of care is sent by the author. practitioner was acting on behalf of.

Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when authoring the request.

Description Indication of the clinical condition indicating why referral/transfer domain or discipline to which the referral or transfer of care request is requested. sent. For example: Pathological Anomalies, Disabled (physical or mental), Behavioral Management. Cardiology Gastroenterology Diabetology.

The reason element gives a short description of why the referral healthcare provider(s) or provider organization(s) who/which is being made, the description expands on this to support a more complete clinical summary. receive the referral/transfer of care request.

There will be a good candidate for a 'markdown' data type. primary receiver. But the request can be received by any number of "copied to" providers or organizations.

The service(s) that is/are requested to be provided to the patient. Description of clinical condition indicating why referral/transfer of care is requested. For example: cardiac pacemaker insertion. Pathological Anomalies, Disabled (physical or mental), Behavioral Management.

Indicates another resource whose existence justifies this request.

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.

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.

The period of time within which the services identified in Comments made about the referral/transfer referral request by any of care is specified or required to occur. the participants.

Use cases: (1) Links to indicate Provenance records for past versions of this resource or fulfilling request or event resources that the requested service is not identify key state transitions or updates that are likely to happen before a specified date, and saving the start date in Period.start; (2) be relevant to indicate that the requested service must happen before a specified date, and saving the end date in Period.end; (3) to indicate that user looking at the requested service must happen during current version of the specified dates ("start" and "end" values). resource.

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.