Care Coordination and 360 Referrals (Proof of Concept)
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: Message Definition - Referral Order Status (O51)

Draft as of 2026-11-01

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<MessageDefinition xmlns="http://hl7.org/fhir">
  <id value="referral-order-status"/>
  <language value="en"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: MessageDefinition referral-order-status</b></p><a name="referral-order-status"> </a><a name="hcreferral-order-status"> </a><p><b>url</b>: <a href="MessageDefinition-referral-order-status.html">MessageDefinition Referral Order Status (O51)</a></p><p><b>version</b>: 0.1.0</p><p><b>name</b>: ReferralOrderStatus</p><p><b>title</b>: Referral Order Status (O51)</p><p><b>status</b>: Draft</p><p><b>experimental</b>: true</p><p><b>date</b>: 2026-11-01</p><p><b>publisher</b>: Kevin Mayfield</p><p><b>contact</b>: <a href="https://github.com/KevinMayfield/PatientCareCoordination">https://github.com/KevinMayfield/PatientCareCoordination</a></p><p><b>description</b>: </p><div><p>FHIR Message equivalent of the IHE 360X HL7 v2.5.1 <code>OSU^O51^OSU_O51</code> order status update.
The <a href="StructureDefinition-ReferralTask.html">Referral Task</a> carries the status
(<code>status</code>, <code>businessStatus</code>, <code>statusReason</code>); for an interim note [PCC-59] or outcome
[PCC-57] the message also carries the clinical document referenced from <code>Task.output</code>.</p>
<p>The message does <strong>not</strong> carry a <code>Patient</code> resource. Both sides of the exchange already
know the patient from the referral, so <code>Task.for</code> identifies the patient by NHS Number
(<code>for.identifier</code>), <code>Task.requester</code> the referrer (professional code) and <code>Task.owner</code>
the Referral Recipient (service identifier), alongside the references.</p>
<table class="grid">
<thead>
<tr>
<th>360X</th>
<th>ORC-1 / ORC-5</th>
<th>Task.businessStatus</th>
</tr>
</thead>
<tbody>
<tr>
<td>Accept [PCC-55]</td>
<td>OK / IP</td>
<td>accepted</td>
</tr>
<tr>
<td>Decline [PCC-55, PCC-56]</td>
<td>UA / CA</td>
<td>declined</td>
</tr>
<tr>
<td>Deferred (NHS, indicative)</td>
<td>OH / HD</td>
<td>deferred</td>
</tr>
<tr>
<td>Redirected (NHS, indicative)</td>
<td>RU / RP</td>
<td>redirected</td>
</tr>
<tr>
<td>Interim Consultation Note [PCC-59]</td>
<td>SC / A</td>
<td>interim-report</td>
</tr>
<tr>
<td>Referral Outcome [PCC-57]</td>
<td>SC / CM</td>
<td>completed</td>
</tr>
<tr>
<td>Cancel Request [PCC-58]</td>
<td>CA / CA</td>
<td>cancel-requested</td>
</tr>
<tr>
<td>Cancel Confirmation [PCC-58]</td>
<td>CR / CA</td>
<td>cancelled</td>
</tr>
</tbody>
</table>
</div><p><b>jurisdiction</b>: <span title="Codes:{urn:iso:std:iso:3166 GB}">United Kingdom of Great Britain and Northern Ireland</span></p><p><b>event</b>: <a href="http://terminology.hl7.org/7.5.0/CodeSystem-v2-0003.html#v2-0003-O51">event: O51</a> (OSU – Order Status Update)</p><p><b>category</b>: Notification</p><h3>Focus</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Profile</b></td><td><b>Min</b></td><td><b>Max</b></td></tr><tr><td style="display: none">*</td><td>Task</td><td><a href="StructureDefinition-ReferralTask.html">Referral Task</a></td><td>1</td><td>1</td></tr></table><p><b>responseRequired</b>: Never</p></div>
  </text>
  <url
       value="https://fhir.acmeexample.org.uk/PatientCareCoordination/MessageDefinition/referral-order-status"/>
  <version value="0.1.0"/>
  <name value="ReferralOrderStatus"/>
  <title value="Referral Order Status (O51)"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2026-11-01"/>
  <publisher value="Kevin Mayfield"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value
             value="https://github.com/KevinMayfield/PatientCareCoordination"/>
    </telecom>
  </contact>
  <description
               value="FHIR Message equivalent of the IHE 360X HL7 v2.5.1 `OSU^O51^OSU_O51` order status update.
The [Referral Task](StructureDefinition-ReferralTask.html) carries the status
(`status`, `businessStatus`, `statusReason`); for an interim note [PCC-59] or outcome
[PCC-57] the message also carries the clinical document referenced from `Task.output`.

The message does **not** carry a `Patient` resource. Both sides of the exchange already
know the patient from the referral, so `Task.for` identifies the patient by NHS Number
(`for.identifier`), `Task.requester` the referrer (professional code) and `Task.owner`
the Referral Recipient (service identifier), alongside the references.

| 360X | ORC-1 / ORC-5 | Task.businessStatus |
|---|---|---|
| Accept [PCC-55] | OK / IP | accepted |
| Decline [PCC-55, PCC-56] | UA / CA | declined |
| Deferred (NHS, indicative) | OH / HD | deferred |
| Redirected (NHS, indicative) | RU / RP | redirected |
| Interim Consultation Note [PCC-59] | SC / A | interim-report |
| Referral Outcome [PCC-57] | SC / CM | completed |
| Cancel Request [PCC-58] | CA / CA | cancel-requested |
| Cancel Confirmation [PCC-58] | CR / CA | cancelled |"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="GB"/>
      <display value="United Kingdom of Great Britain and Northern Ireland"/>
    </coding>
  </jurisdiction>
  <eventCoding>
    <system value="http://terminology.hl7.org/CodeSystem/v2-0003"/>
    <code value="O51"/>
  </eventCoding>
  <category value="notification"/>
  <focus>
    <code value="Task"/>
    <profile
             value="https://fhir.acmeexample.org.uk/PatientCareCoordination/StructureDefinition/ReferralTask"/>
    <min value="1"/>
    <max value="1"/>
  </focus>
  <responseRequired value="never"/>
</MessageDefinition>