HL7 Electronic Health Record System Functional Model, Release 2.1.1
2.1.1 - Normative

HL7 Electronic Health Record System Functional Model, Release 2.1.1, published by HL7 International / Electronic Health Records. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/ehrsfm-ig/ and changes regularly. See the Directory of published versions

## : CPS.4.6.1 Support for Referral Process (Function)

Page standards status: Normative

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

    # - resource -------------------------------------------------------------------

     a fhir:Requirements ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "EHRSFMR2-CPS.4.6.1"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/FMFunction"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/FMFunction>     ] )
      ] ; #
      fhir:language [ fhir:v "en"] ; #
      fhir:text [
    fhir:status [ fhir:v "extensions" ] ;
    fhir:div [ fhir:v "<div xml:lang=\"en\" xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en\">\n    \n    \n    <div id=\"description\"><b>Description <a href=\"https://hl7.org/fhir/versions.html#std-process\" title=\"Informative Content\" class=\"informative-flag\">I</a>:</b> <div><p>The system assists with patient referrals, including compilation of relevant clinical and behavioral health results, demographic and insurance information (if available). Standardized or evidence based protocols for workup prior to referral may also be presented.</p>\n</div></div>\n    \n    \n    \n    <div id=\"requirements\"><b>Criteria <a href=\"https://hl7.org/fhir/versions.html#std-process\" title=\"Normative Content\" class=\"normative-flag\">N</a>:</b></div>\n    \n    <table id=\"statements\" class=\"grid dict\">\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#01\n            </td>\n            <td style=\"padding-left: 4px;\">\n            SHALL\n            \n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system SHALL provide the ability to capture and render clinical and administrative data (e.g., insurance information) as part of the referral process.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#02\n            </td>\n            <td style=\"padding-left: 4px;\">\n            SHOULD\n            \n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system SHOULD provide the ability to capture and render test and procedure results with a referral.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#03\n            </td>\n            <td style=\"padding-left: 4px;\">\n            MAY\n            \n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system MAY provide the ability to capture and render standardized or evidence based protocols (e.g., AHRQ evidence-based practice guidelines) with the referral.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#04\n            </td>\n            <td style=\"padding-left: 4px;\">\n            SHALL\n            \n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system SHALL provide the ability to render clinical and administrative data, as well as test and procedure results to the referred-to provider.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#05\n            </td>\n            <td style=\"padding-left: 4px;\">\n            SHALL\n            \n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system SHALL provide the ability to capture and render referral orders with detail adequate for correct routing to the referred-to provider.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#06\n            </td>\n            <td style=\"padding-left: 4px;\">\n            SHOULD\n            \n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system SHOULD provide the ability to transmit clinical and administrative data, as well as test and procedure results to the referred-to provider.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#07\n            </td>\n            <td style=\"padding-left: 4px;\">\n            SHALL\n            \n                \n                <span style=\"border-radius: 999px;margin: 2px 2px;font-size: 10px;display: inline-block;padding: 3px 5px;letter-spacing: 0.5px;line-height: 1;white-space: nowrap;background-color: #e5f5e5;color: #388e3c;border: 1px solid #a2d1a2;\">dependent</span>\n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system SHALL provide the ability to capture and render age appropriate data as part of the referral process according to scope of practice. (e.g., inclusion of growth chart in pediatric referral).</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#08\n            </td>\n            <td style=\"padding-left: 4px;\">\n            SHOULD\n            \n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system SHOULD provide the ability to capture a provider's schedule for receiving referrals.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#09\n            </td>\n            <td style=\"padding-left: 4px;\">\n            SHOULD\n            \n                \n            \n            <span style=\"border-radius: 999px;margin: 2px 2px;font-size: 10px;display: inline-block;padding: 3px 5px;letter-spacing: 0.5px;line-height: 1;white-space: nowrap;background-color: #f3e5ff;color: #7b1fa2;border: 1px solid #d1a3ff;\">conditional</span>\n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>IF the system provides the ability to capture provider schedules for receiving referrals, THEN the system SHOULD determine and render available provider appointments based on their schedules at the time of referral order entry.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n        <tr>\n            <td style=\"padding-left: 4px;\">\n            CPS.4.6.1#10\n            </td>\n            <td style=\"padding-left: 4px;\">\n            MAY\n            \n                \n            \n            \n            \n            </td>\n            <td style=\"padding-left: 4px;\" class=\"requirement\">\n                <div><p>The system MAY provide the ability to transmit a referral to multiple providers.</p>\n</div>\n                \n            </td>\n        </tr>\n        \n    </table>\n</div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:extension ( [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status>     ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "normative"     ]
      ] [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-wg>     ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "ehr"     ]
      ] ) ; #
      fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/Requirements/EHRSFMR2-CPS.4.6.1"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/Requirements/EHRSFMR2-CPS.4.6.1>
      ] ; #
      fhir:version [ fhir:v "2.1.1"] ; #
      fhir:name [ fhir:v "CPS_4_6_1_Support_for_Referral_Process"] ; #
      fhir:title [ fhir:v "CPS.4.6.1 Support for Referral Process (Function)"] ; #
      fhir:status [ fhir:v "active"] ; #
      fhir:date [ fhir:v "2025-12-13T09:06:06+00:00"^^xsd:dateTime] ; #
      fhir:publisher [ fhir:v "HL7 International / Electronic Health Records"] ; #
      fhir:contact ( [
        ( fhir:telecom [
    fhir:system [ fhir:v "url" ] ;
    fhir:value [ fhir:v "http://www.hl7.org/Special/committees/ehr" ]     ] )
      ] ) ; #
      fhir:description [ fhir:v "Evaluate referrals within the context of a patient's healthcare data."] ; #
      fhir:jurisdiction ( [
        ( fhir:coding [
    fhir:system [
    fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ;
    fhir:l <http://unstats.un.org/unsd/methods/m49/m49.htm>       ] ;
    fhir:code [ fhir:v "001" ] ;
    fhir:display [ fhir:v "World" ]     ] )
      ] ) ; #
      fhir:purpose [ fhir:v "The system assists with patient referrals, including compilation of relevant clinical and behavioral health results, demographic and insurance information (if available). Standardized or evidence based protocols for workup prior to referral may also be presented."] ; #
      fhir:statement ( [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-01" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#01" ] ;
        ( fhir:conformance [ fhir:v "SHALL" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system SHALL provide the ability to capture and render clinical and administrative data (e.g., insurance information) as part of the referral process." ] ;
    fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 DC.2.4.4.1#1" ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-02" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#02" ] ;
        ( fhir:conformance [ fhir:v "SHOULD" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system SHOULD provide the ability to capture and render test and procedure results with a referral." ] ;
    fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 DC.2.4.4.1#2" ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-03" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#03" ] ;
        ( fhir:conformance [ fhir:v "MAY" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system MAY provide the ability to capture and render standardized or evidence based protocols (e.g., AHRQ evidence-based practice guidelines) with the referral." ] ;
    fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 DC.2.4.4.1#3" ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-04" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#04" ] ;
        ( fhir:conformance [ fhir:v "SHALL" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system SHALL provide the ability to render clinical and administrative data, as well as test and procedure results to the referred-to provider." ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-05" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#05" ] ;
        ( fhir:conformance [ fhir:v "SHALL" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system SHALL provide the ability to capture and render referral orders with detail adequate for correct routing to the referred-to provider." ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-06" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#06" ] ;
        ( fhir:conformance [ fhir:v "SHOULD" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system SHOULD provide the ability to transmit clinical and administrative data, as well as test and procedure results to the referred-to provider." ] ;
    fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 DC.2.4.4.1#4" ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v true       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-07" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#07" ] ;
        ( fhir:conformance [ fhir:v "SHALL" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system SHALL provide the ability to capture and render age appropriate data as part of the referral process according to scope of practice. (e.g., inclusion of growth chart in pediatric referral)." ] ;
    fhir:derivedFrom [ fhir:v "PHFP DC.2.4.4.1#6" ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-08" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#08" ] ;
        ( fhir:conformance [ fhir:v "SHOULD" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system SHOULD provide the ability to capture a provider's schedule for receiving referrals." ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-09" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#09" ] ;
        ( fhir:conformance [ fhir:v "SHOULD" ] ) ;
    fhir:conditionality [ fhir:v true ] ;
    fhir:requirement [ fhir:v "IF the system provides the ability to capture provider schedules for receiving referrals, THEN the system SHOULD determine and render available provider appointments based on their schedules at the time of referral order entry." ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent"^^xsd:anyURI ;
    fhir:l <http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent>       ] ;
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] ) ;
    fhir:key [ fhir:v "EHRSFMR2-CPS.4.6.1-10" ] ;
    fhir:label [ fhir:v "CPS.4.6.1#10" ] ;
        ( fhir:conformance [ fhir:v "MAY" ] ) ;
    fhir:conditionality [ fhir:v false ] ;
    fhir:requirement [ fhir:v "The system MAY provide the ability to transmit a referral to multiple providers." ]
      ] ) . #