Name Flags Card. Type Description & Constraints ReferralRequest C 0..* ReferralRequest A request for referral or transfer of care inv-dh-rr-01: One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva' meta 1..1 Meta Metadata about the resource profile 1..* uri Profiles this resource claims to conform to identifier S 0..* Identifier Business identifier status S 1..1 code draft | active | suspended | cancelled | completed | entered-in-error | unknown Fixed Value: completed intent S 1..1 code proposal | plan | order Fixed Value: order subject S 1..1 Reference(AU Base Patient) Patient referred to care or transfer requester S 1..1 BackboneElement Who/what is requesting service agent S 1..1 Reference(AU Base Practitioner) Individual making the request onBehalfOf S 0..1 Reference(AU Base Organisation) Organization agent is acting for specialty S 0..1 CodeableConcept The clinical specialty (discipline) that the referral is requested for Binding: https://healthterminologies.gov.au/fhir/ValueSet/anzsco-1 (extensible) Documentation for this format
The purpose of this profile is to define a representation of service item claimed information, including practitioner that requested the service, in a claim against the Medicare Benefits Schedule (MBS) or Department of Veterans' Affairs (DVA) for the electronic exchange of digital health information between Medicare repositories and the My Health Record system infrastructure in Australia.
Copyright © 2022 Australian Digital Health Agency - All rights reserved. This content is licensed under a Creative Commons Attribution 4.0 International License. See https://creativecommons.org/licenses/by/4.0/.
A request for referral or transfer of care
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.
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL NOT contain any narrative
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty()
not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))
One meta.profile SHALL have value 'http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva'
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional Content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to 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.
The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.
The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
When the resource last changed - e.g. when the version changed.
This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.
Profiles this resource claims to conform to
A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).
It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Security Labels applied to this resource
Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Security Labels from the Healthcare Privacy and Security Classification System.
Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
May be used to represent additional information that is not part of the basic definition of the resource. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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 is allowed to 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.
Business identifier that uniquely identifies the referral/care transfer request instance.
A protocol, guideline, orderset or other definition that is adhered to in whole or in part by this request.
Indicates any plans, proposals or orders that this request is intended to satisfy - in whole or in part.
Completed or terminated request(s) whose function is taken by this new request.
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.
Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.
The business identifier of the logical "grouping" request/order that this referral is a part of.
Allows multiple orders to be collected as part of a single requisition.
draft | active | suspended | cancelled | completed | entered-in-error | unknown
The status of the authorization/intention reflected by the referral request record.
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Workflow status is handled by the Task resource.
Distinguishes the "level" of authorization/demand implicit in this request.
The same resource structure is used when capturing proposals/recommendations, plans and actual requests.
Codes identifying the stage lifecycle stage of a request
Referral/Transition of care request type
An indication of the type of referral (or where applicable the type of transfer of care) request.
Codes for types of referral; e.g. consult, transfer, temporary transfer.
Urgency of referral / transfer of care request
An indication of the urgency of referral (or where applicable the type of transfer of care) request.
Codes indicating the relative priority of the referral.
Actions requested as part of the referral
The service(s) that is/are requested to be provided to the patient. For example: cardiac pacemaker insertion.
Codes indicating the types of services that might be requested as part of a referral.
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 encounter at which the request for referral or transfer of care is initiated.
When the service(s) requested in the referral should occur
The period of time within which the services identified in the referral/transfer of care is specified or required to occur.
When the occurrenceDateTime is used, then it is indicating that the requested service must happen before the specified date.
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).
Date/DateTime of creation for draft requests and date of activation for active requests.
The individual who initiated the request and has responsibility for its activation.
All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
onBehalfOf can only be specified if agent is practitioner or device
(agent.resolve() is Device) or (agent.resolve() is Practitioner) or onBehalfOf.exists().not()
contains(f:agent/f:reference/@value, '/Practitioner/') or contains(f:agent/f:reference/@value, '/Device/') or not(exists(f:onBehalfOf))
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 that contains it. Usually modifier elements provide negation or qualification. In order 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 is allowed to 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.
The device, practitioner, etc. who initiated the request.
The organization the device or 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.
The clinical specialty (discipline) that the referral is requested for
Indication of the clinical domain or discipline to which the referral or transfer of care request is sent. For example: Cardiology Gastroenterology Diabetology.
Receiver of referral / transfer of care request
The healthcare provider(s) or provider organization(s) who/which is to receive the referral/transfer of care request.
There will be a primary receiver. But the request can be received by any number of "copied to" providers or organizations.
Practitioner: PRD-2/PRD-7 where PRD-3 = RT; Organization: PRD-10 where PRD-3 = RT
Reason for referral / transfer of care request
Description of clinical condition indicating why referral/transfer of care is requested. For example: Pathological Anomalies, Disabled (physical or mental), Behavioral Management.
Codes indicating why the referral is being requested.
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.
Additonal information to support referral or transfer of care request
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.
Comments made about the referral request by any of the participants.
Links to Provenance records for past versions of this resource or fulfilling request or event resources that identify key state transitions or updates that are likely to be relevant to a user looking at the current version of the 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.
.inboundRelationship(typeCode=SUBJ].source[classCode=CACT, moodCode=EVN]