Care Coordination and 360 Referrals (Proof of Concept)
0.1.0 - proof-of-concept United Kingdom flag

Care Coordination and 360 Referrals (Proof of Concept) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Appointment Notification [PCC-60] and No-Show Notification [PCC-61]

The 360X Scheduling Option: the Referral Recipient tells the Referral Initiator about appointments booked to carry out the referral [PCC-60] and when the patient does not attend [PCC-61]. Both are optional.

References

360X notes that many organisations have other, fuller ways of sharing appointments, so the option may not be needed. In England, eRS and BaRS bookings already tell the referrer; this option covers appointments booked locally by the provider. When the GP practice is the Referral Recipient (for example NHS 111 or a virtual ward arranging a GP follow-up), the booking is made directly with GP Connect Appointment Management, which returns the Appointment.

Appointment Notification [PCC-60]

sequenceDiagram
    participant RI as Referral Initiator
    participant RR as Referral Recipient
    RR -->> RR: Book appointment
    RR ->> RI: SIU^S12 new / S13 reschedule / S15 cancel<br/>Appointment
Message HL7 v2 FHIR (Referral Appointment) Task businessStatus
New appointment SIU^S12^SIU_S12 status booked appointment-booked
Reschedule SIU^S13^SIU_S12 status booked, new start appointment-rescheduled
Cancel appointment SIU^S15^SIU_S12 status cancelled appointment-cancelled
Data item 360X HL7 v2 FHIR
Appointment ID SCH-2 identifier
Reason for appointment SCH-6 LOINC 57133-1 serviceType, reasonCode
Referral ID SCH-26 basedOn (identifier)
Date and time TQ1-7 (at least the date) start, end
Action code RGS-2 A -
Appointment provider AIP-3 (should) participant.actor

Example: Referral Appointment.

If the Referral Recipient implements the option, every appointment for the referral triggers a notification, one per appointment. A Referral Initiator that implements it SHALL record and show them; otherwise it may ignore them.

No-Show Notification [PCC-61]

sequenceDiagram
    participant RI as Referral Initiator
    participant RR as Referral Recipient
    RR -->> RR: Patient did not attend
    RR ->> RI: SIU^S26 / Appointment noshow
Data item 360X HL7 v2 FHIR
Appointment ID SCH-2 (matches the notification) identifier
Referral ID SCH-26 basedOn
Date and time TQ1-7 start
Action code RGS-2 D status noshow
Appointment provider AIP-3 (may) participant.actor

The Referral Task businessStatus becomes no-show. The referral stays open: the Referral Recipient may rebook, or end it with a Referral Decline [PCC-56] (reason no-show) - the NHS "discharged back to GP after DNA". Without the Scheduling Option, the decline is the only way to report the no-show.