Referral Profile

Canonical	../StructureDefinition/nexus-core-referral
Status	draft · 1.26.0
Base	ServiceRequest (constraint)
Source	FSH · JSON

Defines the Nexus EMR FHIR profile for referrals: a request that another clinician or service accept the patient, for consultation, second opinion, or ongoing management. Aligned to the pan-Canadian CA-eReC / Ontario eReferral contract, which is the shape Nexus already exchanges with Ocean. Distinct from NexusEmrCoreServiceRequest, which governs laboratory, imaging and procedure ORDERS and fixes intent to order.

Access

What the endpoint offers

Declared for ServiceRequest by the capability statements this IG publishes. One row per statement; follow it for the rest of what that statement says about this type.

Capability statement	Interactions	Search parameters
Server Capability Statement	read vread history-instance search-type create update delete	none declared

A cell reading none declared means that statement declares none, which is not the same as the endpoint having none. See how to read a capability statement for what a declared interaction and a declared search parameter do -- and do not -- promise.

SMART on FHIR scopes

ServiceRequest is reachable by a SMART on FHIR app. These are the scopes an app can request, and the platform permission each one resolves to.

Request this scope	Grants	Permission required
user/ServiceRequest.rs	Read and search	servicerequest:read
user/ServiceRequest.cu	Create and update	servicerequest:write
user/ServiceRequest.d	Delete	servicerequest:delete
user/ServiceRequest.cruds	Everything above	servicerequest:read, servicerequest:write, servicerequest:delete

ServiceRequest is in the FHIR patient compartment, so every suffix above also works with the patient context (patient/ServiceRequest.rs), which narrows the grant to the launch patient's records. The permission required is the same either way.

Reading the suffix

A clinical scope is <context>/<ResourceType>.<interactions>.

• Context is patient (the launch patient's data only, and only for resource types in the FHIR patient compartment) or user (everything the authenticated user may see, valid for any type). There is no system context.
• Interactions are the letters c create, r read, u update, d delete, s search, written in cruds order. Order does not matter on the way in: ServiceRequest.sr and ServiceRequest.rs are the same scope.
• The older SMART v1 suffixes still work and fold on arrival: .read becomes .rs, .write becomes .cud, and .* becomes .cruds.
• Wildcards (patient/*.rs) expand over the SMART-exposed resource types only, never over everything this IG profiles.

Ask for a whole permission, or none of it

The platform has one read permission covering both r and s, and one write permission covering both c and u. A scope asking for half of either could only be granted by handing over more than it asked for, so it is refused rather than quietly widened: request ServiceRequest.rs, not ServiceRequest.r.

An unrecognised or ungrantable scope is rejected outright. It never silently resolves to an empty grant, which a caller could mistake for "no narrowing needed".