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.
Elements / Snapshot
The full effective definition: base ServiceRequest with this profile's constraints applied.
| Element | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| ServiceRequest | 0..* | Nexus EMR Referral Invariants: dom-2, dom-3, dom-4, dom-5, dom-6, prr-1, nexus-note-extension-not-where-native, referral-code-has-text, referral-category-coded |
||
| id | 0..1 | http://hl7.org/fhirpath/System.String | Logical id of this artifact i | |
| meta | 0..1 | Meta | Metadata about the resource Invariants: ele-1 |
|
| id | 0..1 | http://hl7.org/fhirpath/System.String | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations i Slicing: value:url (open) Invariants: ele-1, ext-1 |
|
| versionId | 0..1 | id | Version specific identifier i Invariants: ele-1 |
|
| lastUpdated | 0..1 | instant | When the resource version last changed i Invariants: ele-1 |
|
| source | S | 0..1 | uri | Identifies EMR instance & pipeline version the resource came from i Invariants: ele-1 |
| profile | 0..* | canonical | Profiles this resource claims to conform to i Invariants: ele-1 |
|
| security | 0..* | Coding | Security Labels applied to this resource i Binding: security-labels ( extensible)Invariants: ele-1 |
|
| tag | 0..* | Coding | Tags applied to this resource i Binding: common-tags ( example)Invariants: ele-1 |
|
| implicitRules | ?! | 0..1 | uri | A set of rules under which this content was created i Invariants: ele-1 |
| language | 0..1 | code | Language of the resource content i Binding: languages ( preferred)Invariants: ele-1 |
|
| text | S | 0..1 | Narrative | Narrative i Invariants: ele-1 |
| contained | 0..* | Resource | Contained, inline Resources i | |
| extension | 0..* | Extension | Additional content defined by implementations i Invariants: ele-1, ext-1 |
|
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored i Invariants: ele-1, ext-1 |
| identifier | S | 0..* | Identifier | Business identifier(s) for the referral i Invariants: ele-1 |
| id | 0..1 | http://hl7.org/fhirpath/System.String | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations i Slicing: value:url (open) Invariants: ele-1, ext-1 |
|
| use | ?! | 0..1 | code | usual | official | temp | secondary | old (If known) i Binding: identifier-use ( required)Invariants: ele-1 |
| type | 0..1 | CodeableConcept | Description of identifier i Binding: identifier-type ( extensible)Invariants: ele-1 |
|
| system | 1..1 | uri | The namespace for the identifier value i Invariants: ele-1 |
|
| value | 1..1 | string | The value that is unique i Invariants: ele-1 |
|
| period | 0..1 | Period | Time period when id is/was valid for use Invariants: ele-1 |
|
| assigner | 0..1 | Reference(Organization) | Organization that issued id (may be just text) i Invariants: ele-1 |
|
| instantiatesCanonical | 0..* | canonical | Instantiates FHIR protocol or definition i Invariants: ele-1 |
|
| instantiatesUri | 0..* | uri | Instantiates external protocol or definition i Invariants: ele-1 |
|
| basedOn | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills Invariants: ele-1 |
|
| replaces | 0..* | Reference(ServiceRequest) | What request replaces Invariants: ele-1 |
|
| requisition | 0..1 | Identifier | Composite Request ID i Invariants: ele-1 |
|
| status | S ?! | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error i Binding: request-status ( required)Invariants: ele-1 |
| intent | S ?! | 1..1 | code | proposal i Fixed: proposalBinding: request-intent ( required)Invariants: ele-1 |
| category | S | 1..* | CodeableConcept | Receiving service or specialty i Binding: Referral Service Type Value Set ( extensible)Invariants: ele-1 |
| priority | S | 0..1 | code | routine | urgent | asap | stat Binding: request-priority ( required)Invariants: ele-1 |
| doNotPerform | ?! | 0..1 | boolean | True if service/procedure should not be performed i Invariants: ele-1 |
| code | S | 0..1 | CodeableConcept | Specific requested service, when more precise than category i Binding: procedure-code ( example)Invariants: ele-1 |
| orderDetail | 0..* | CodeableConcept | Additional order information i Binding: servicerequest-orderdetail ( example)Invariants: ele-1 |
|
| quantity[x] | 0..1 | Quantity, Ratio, Range | Service amount Invariants: ele-1 |
|
| subject | S | 1..1 | Reference(Patient Profile) | The patient being referred Invariants: ele-1 |
| encounter | S | 0..1 | Reference(Encounter Profile) | Encounter in which the referral was created Invariants: ele-1 |
| occurrence[x] | S | 0..1 | dateTime, Period, Timing | When the referred service should occur Invariants: ele-1 |
| asNeeded[x] | 0..1 | boolean, CodeableConcept | Preconditions for service Binding: medication-as-needed-reason ( example)Invariants: ele-1 |
|
| authoredOn | S | 1..1 | dateTime | Date the referral was authored i Invariants: ele-1 |
| requester | S | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who is making the referral i Invariants: ele-1 |
| performerType | 0..1 | CodeableConcept | Performer role i Binding: participant-role ( example)Invariants: ele-1 |
|
| performer | S | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | The service or clinician the referral is directed to i Invariants: ele-1 |
| locationCode | 0..* | CodeableConcept | Requested location Binding: v3-ServiceDeliveryLocationRoleType ( example)Invariants: ele-1 |
|
| locationReference | 0..* | Reference(Location) | Requested location Invariants: ele-1 |
|
| reasonCode | S | 0..* | CodeableConcept | Why the referral is being made i Binding: procedure-reason ( example)Invariants: ele-1 |
| reasonReference | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service i Invariants: ele-1 |
|
| insurance | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage Invariants: ele-1 |
|
| supportingInfo | S | 0..* | Reference(Resource) | Prior results, notes and documents sent with the referral i Invariants: ele-1 |
| specimen | 0..* | Reference(Specimen) | Procedure Samples i Invariants: ele-1 |
|
| bodySite | 0..* | CodeableConcept | Location on Body i Binding: body-site ( example)Invariants: ele-1 |
|
| note | S | 0..* | Annotation | Free-text notes on the referral Invariants: ele-1 |
| patientInstruction | 0..1 | string | Patient or consumer-oriented instructions Invariants: ele-1 |
|
| relevantHistory | 0..* | Reference(Provenance) | Request provenance i Invariants: ele-1 |