Table of Contents

Referral

The Referral data model is used to communicate patient demographic and clinical information from a referring provider to send the patient's case to another provider. This typically differs from a consultation, where a provider may review a patient without assuming authority over the patient’s care. Referrals can be internal to an organization (e.g., from one department to another) or external between organizations.

This data model is useful to maintain the administrative aspects of a referral order. Sending a referral initiates the message, then you can use the data model to track the progress of that referral throughout the authorization process from insurance and scheduling the referral.

EHR systems with advanced referral management capabilities and robust interfacing libraries typically support the Referral data model via an HL7v2 REF interface or their own proprietary API.

Alternatively, some EHR systems may not support the Referral data model. However, since a referral can be a specific type of order when it pertains to a transfer of patient responsibility for specialty care, an EHR system may support creating a referral with the Order data model instead. Just note that you may not be able to update the referral details after it’s created. This customized type of workflow varies per EHR system. We can help you determine how to best manage referrals, whether with the Referral or Order data models.