Proof of concept - not an authoritative source.

The information exchanged during a closed loop referral, from the referral request to the referral outcome. Based on the data items of the IHE 360X transactions (PCC TF-2 3.55 to 3.61), FHIR Workflow and HL7 v2 orders, with the UBRN from eRS. It is the same for a referral to an outpatient clinic, a community service or a virtual ward. National services such as BaRS are mapped onto this model (see the BaRS review), not the other way round. The PRSB Clinical Referral Information Standard v1.0 gives the clinical headings.

The referral stays small: the clinical content is in separate documents referenced as supporting information - a Discharge Report or clinic letter for the episode, a Patient Summary and referral forms. A referral may be one activity of a Care Plan.

The Mappings tab shows each element in HL7 v2 (360X) and FHIR.

Unique identifier assigned by the Referral Initiator, used in every message about the referral

eRS identifier, if the referral was made through eRS

The patient referred

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Traced NHS Number

Referral Initiator's identifier (360X sourcePatientId), and any identifier the Referral Recipient adds

Name, date of birth, sex, address

The Referral Initiator

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Professional registration or GP code

ODS code

The Referral Recipient

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

eRS service ID, Directory of Services ID or local service

Named clinician, if any

ODS code

Specialty, clinic type or referral procedure

routine, urgent, urgent suspected cancer, two week wait

The date by which the service should be provided (urgency converted to a date)

Period the referral is valid for

Coded (SNOMED CT) or text

The clinical question for the Referral Recipient

The referrer's account of the episode that led to the referral - Discharge Report (HL7 Europe HDR) or clinic letter

The patient's background (HL7 Europe Patient Summary), when the recipient cannot query the record

Forms completed for the referral - see Referral Forms

Findings needed by the recipient, e.g. vital signs

The care plan this referral carries out, if any

When the referral was made

360X state - see Referral Workflow Status

Free text at least

Appointments booked to carry out the referral

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Unique identifier of the appointment

At least the date

Clinician or service seeing the patient

booked, rescheduled, cancelled, no-show

Results sent before the end of care

Report that closes the loop - consultation note, discharge report or care plan

Proof of concept - not an authoritative source.

The information exchanged during a closed loop referral, from the referral request to the referral outcome. Based on the data items of the IHE 360X transactions (PCC TF-2 3.55 to 3.61), FHIR Workflow and HL7 v2 orders, with the UBRN from eRS. It is the same for a referral to an outpatient clinic, a community service or a virtual ward. National services such as BaRS are mapped onto this model (see the BaRS review), not the other way round. The PRSB Clinical Referral Information Standard v1.0 gives the clinical headings.

The referral stays small: the clinical content is in separate documents referenced as supporting information - a Discharge Report or clinic letter for the episode, a Patient Summary and referral forms. A referral may be one activity of a Care Plan.

The Mappings tab shows each element in HL7 v2 (360X) and FHIR.

Unique identifier assigned by the Referral Initiator, used in every message about the referral

eRS identifier, if the referral was made through eRS

The patient referred

Traced NHS Number

Referral Initiator's identifier (360X sourcePatientId), and any identifier the Referral Recipient adds

Name, date of birth, sex, address

The Referral Initiator

Professional registration or GP code

ODS code

The Referral Recipient

eRS service ID, Directory of Services ID or local service

Named clinician, if any

ODS code

Specialty, clinic type or referral procedure

routine, urgent, urgent suspected cancer, two week wait

The date by which the service should be provided (urgency converted to a date)

Period the referral is valid for

Coded (SNOMED CT) or text

The clinical question for the Referral Recipient

The referrer's account of the episode that led to the referral - Discharge Report (HL7 Europe HDR) or clinic letter

The patient's background (HL7 Europe Patient Summary), when the recipient cannot query the record

Forms completed for the referral - see Referral Forms

Findings needed by the recipient, e.g. vital signs

The care plan this referral carries out, if any

When the referral was made

360X state - see Referral Workflow Status

Free text at least

Appointments booked to carry out the referral

Unique identifier of the appointment

At least the date

Clinician or service seeing the patient

booked, rescheduled, cancelled, no-show

Results sent before the end of care

Report that closes the loop - consultation note, discharge report or care plan

Proof of concept - not an authoritative source.

The information exchanged during a closed loop referral, from the referral request to the referral outcome. Based on the data items of the IHE 360X transactions (PCC TF-2 3.55 to 3.61), FHIR Workflow and HL7 v2 orders, with the UBRN from eRS. It is the same for a referral to an outpatient clinic, a community service or a virtual ward. National services such as BaRS are mapped onto this model (see the BaRS review), not the other way round. The PRSB Clinical Referral Information Standard v1.0 gives the clinical headings.

The referral stays small: the clinical content is in separate documents referenced as supporting information - a Discharge Report or clinic letter for the episode, a Patient Summary and referral forms. A referral may be one activity of a Care Plan.

The Mappings tab shows each element in HL7 v2 (360X) and FHIR.

Unique identifier assigned by the Referral Initiator, used in every message about the referral

eRS identifier, if the referral was made through eRS

The patient referred

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Traced NHS Number

Referral Initiator's identifier (360X sourcePatientId), and any identifier the Referral Recipient adds

Name, date of birth, sex, address

The Referral Initiator

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Professional registration or GP code

ODS code

The Referral Recipient

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

eRS service ID, Directory of Services ID or local service

Named clinician, if any

ODS code

Specialty, clinic type or referral procedure

routine, urgent, urgent suspected cancer, two week wait

The date by which the service should be provided (urgency converted to a date)

Period the referral is valid for

Coded (SNOMED CT) or text

The clinical question for the Referral Recipient

The referrer's account of the episode that led to the referral - Discharge Report (HL7 Europe HDR) or clinic letter

The patient's background (HL7 Europe Patient Summary), when the recipient cannot query the record

Forms completed for the referral - see Referral Forms

Findings needed by the recipient, e.g. vital signs

The care plan this referral carries out, if any

When the referral was made

360X state - see Referral Workflow Status

Free text at least

Appointments booked to carry out the referral

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

• value @ url

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Unique identifier of the appointment

At least the date

Clinician or service seeing the patient

booked, rescheduled, cancelled, no-show

Results sent before the end of care

Report that closes the loop - consultation note, discharge report or care plan