Bidirectional Services eReferral (BSeR)
2.0.0-ballot - STU2 United States of America flag

Bidirectional Services eReferral (BSeR), published by HL7 Public Health Working Group. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of and changes regularly. See the Directory of published versions

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Official URL: Version: 2.0.0-ballot
Active as of 2024-04-17 Computable Name: BSeRBidirectionalServicesEReferral
Other Identifiers: OID:2.16.840.1.113883.4.642.40.33

Note to Ballot Commenters

We are seeking specific feedback on the following issues:

  • Is it realistic for community-based organizations (CBOs) to offer secure subscriptions to data in their systems? How would that work when there is an intermediary? When the intermediary is a pure pass through?
  • In the Notify of Referral step in Referral - Notify and Pull should both the Task and ServiceRequest be sent, or should just the Task be sent? Should the resource(s) that is sent include all its referenced resources?
  • We believe that sometimes the Intermediary (CBO Hub or Healthcare Information Exchange (HIE)) will act on behalf of the CBO and will present the CBO with web access to the data at the intermediary and sometimes the intermediary will act as a “pass through” and full functionality will exist at the CBO. We have represented one of each option in the interaction diagrams (with intermediary). Should we represent both of these possibilities for the both transactions (Referral - Push (with intermediary) and Referral - Notify and Pull (with intermediary)) use cases?


The Bidirectional Services eReferral (BSeR) FHIR implementation guide (IG) provides guidance for using the HL7 Fast Healthcare Interoperability Resources (FHIR) standard as an exchange format for clinical and non-clinical referrals to be communicated in the form of service requests. It is a collection of profiled FHIR resources designed for use in information exchanges supporting the placement of a service request by a referral initiating provider and the reporting of service delivery outcomes by a referral recipient provider. The goal of the BSeR project is to streamline and enhance the efficacy of the exchange of health information between health care systems and community services organizations involved in addressing chronic health conditions by establishing information exchange standards for electronic referrals and referral outcome reporting.

How to Read This Guide

This Guide is divided into several pages which are listed at the top of each page in the menu bar.

Other Information

This guide is compliant with FHIR Release 4.

For Clinical Safety Information please refer to the FHIR Implementer’s Safety Checklist.

Disclaimer: All proprietary documents, guides, guidance, standards, codes, and values contained herein remain the property of their respective Standards Developing Organization (SDO). HL7 does not make any claim to ownership herein.