SDOH Clinical Care, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 2.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-sdoh-clinicalcare/ and changes regularly. See the Directory of published versions
Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/CapabilityStatement/SDOHCC-ReferralRecipient | Version: 2.2.0 | |||
Standards status: Trial-use | Computable Name: SDOHCC_ReferralRecipient |
This resource describes the required and desired behavior of systems acting as SDOH clinical care 'referral recipients'. These are typically community-based organizations that can provide services such as food bank access, housing remediation, etc.
In some cases, a referral recipient might actually further refer the patient to a downstream service provider through non-FHIR means. In such cases, the system is still treated as a 'referral recipient' rather than a Coordination Platform because, from a FHIR interface perspective, the referral process 'stops' with that system. Referral recipients must be able to receive or monitor for Tasks issued by Referral Sources and Coordination Platforms. They must also be able to respond to access the ServiceRequest representing the referral pointed to by the Task and any relevant information referenced by the referral, update the Task with their acceptance or rejection of the referral, and finally provide information about what interventions were actually performed using the Procedure resource.\n\n There are actually two types of referral recipients defined in this implementation guide. This CapabilityStatement describes the expected behavior of more sophisticated service delivery systems that are capable of exposing a FHIR service and persisting Tasks and Procedures in their own environment. A separate set of interface expectations is defined for 'Light' Referral Recipients that are not capable of exposing an endpoint and where the Task and any resulting Procedures must be stored in the requesting system's database.
Raw OpenAPI-Swagger Definition file | Download
Generated Narrative: CapabilityStatement SDOHCC-ReferralRecipient
xml
, json
Note to Implementers: FHIR Capabilities
Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.
client
The clinical care referral recipient needs to access information from and update information in SDOH clinical care referral sources and/or coordination platforms that have solicited the filling of SDOH-related referrals by this system
SMART-on-FHIR
Implementations must meet the general privacy & security requirements documented in this implementation guide.
batch
interaction described as follows:Allows polling for changes to multiple resource types simultaneously
The summary table lists the resources that are part of this configuration, and for each resource it lists:
_include
_revinclude
Resource Type | Profile | R | S | U | C | Searches | _include | _revinclude | Operations |
---|---|---|---|---|---|---|---|---|---|
CareTeam | Supported Profiles US Core CareTeam Profile | y | y | _id, _lastUpdated | |||||
Condition | Supported Profiles SDOHCC Condition | y | y | _id, _lastUpdated, category, clinical-status, code, patient, verification-status | |||||
Consent | Supported Profiles SDOHCC Consent | y | y | _id, _lastUpdated, source-reference | Consent:source-reference:DocumentReference | ||||
Device | Supported Profiles Device | y | y | _id, _lastUpdated | |||||
DocumentReference | Supported Profiles US Core DocumentReference Profile | y | y | _id, _lastUpdated | |||||
Goal | Supported Profiles SDOHCC Goal | y | y | _id, _lastUpdated, achievement-status, category, lifecycle-status, patient, target-date | |||||
HealthcareService | Supported Profiles SDOHCC Healthcare Service | y | y | _id, _lastUpdated, location | |||||
Location | Supported Profiles SDOHCC Location | y | y | _id, _lastUpdated | |||||
Observation | Supported Profiles SDOHCC Observation Assessment SDOHCC Observation Screening Response SDOHCC Observation Ethnicity OMB SDOHCC Observation Race OMB SDOHCC Observation Gender Identity SDOHCC Observation Personal Characteristic SDOHCC Observation Personal Pronouns SDOHCC Observation Recorded Sex Gender SDOHCC Observation Sexual Orientation | y | y | _id, _lastUpdated, category, code, code-value-concept, date, derived-from, patient, status | |||||
Organization | Supported Profiles US Core Organization Profile | y | y | _id, _lastUpdated | |||||
Patient | Supported Profiles US Core Patient Profile | y | y | _id, _lastUpdated | |||||
Practitioner | Supported Profiles US Core Practitioner Profile | y | y | _id, _lastUpdated | |||||
PractitionerRole | Supported Profiles US Core PractitionerRole Profile | y | y | _id, _lastUpdated, organization, practitioner | PractitionerRole:organization , PractitionerRole:practitioner | ||||
Procedure | Supported Profiles SDOHCC Procedure | y | y | y | y | _id, _lastUpdated, based-on, category, code, date, patient, performer, status | |||
RelatedPerson | Supported Profiles RelatedPerson | y | y | _id, _lastUpdated | |||||
ServiceRequest | Supported Profiles SDOHCC ServiceRequest | y | y | _id, _lastUpdated, category, code, intent, occurrence, patient, performer, requester, status, supporting-info | HealthCareService:location , ServiceRequest:supporting-info , ServiceRequest:pertains-to-goal , ServiceRequest:patient , ServiceRequest:requester , ServiceRequest:performer , PractitionerRole:practitioner , PractitionerRole:organization | ||||
Subscription | Supported Profiles R4/B Topic-Based Subscription | y | y | $status |
literal
read
Allows the system to retrieve a CareTeam that is the intended performer of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved CareTeams that are the intended performer of ServiceRequests.
For referral sources that receive referrals from upstream systems, used to access information about the intended performer of a ServiceRequest when the performer is a specific team of people. Note: Conformance expectations for this resource are lower because CareTeam performers are expected to be uncommon in most SDOH uses
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known CareTeam records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve a Condition that is the reason for a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved Conditions that are referenced by ServiceRequests.
For referral sources that receive referrals from upstream systems, used to access information about a patient's SDOH-related conditions, particularly those that are the reason for a referral
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Condition records - and more specifically, retrieving more than one in a single call to poll for updates |
SHALL | category | token | Allows filtering to only SDOH-related conditions |
SHALL | patient | reference | Allows filtering to only conditions associated with a specific patient. Some systems will require that searches be patient-specific |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
SHOULD | clinical-status | token | Allows filtering to only active conditions |
SHOULD | code | token | Allows filtering to only specific SDOH conditions or sets of conditions |
SHOULD | verification-status | token | Allows filtering to exclude refuted or entered-in-error conditions |
literal
read
Allows the system to retrieve a Consent referenced as a 'supportingInformation' item of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved Consents related to ServiceRequests of interest.
Used to access the consent that authorizes disclosure of ServiceRequest information to non-HIPAA-covered entities
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known consent records - and more specifically, retrieving more than one in a single call to poll for updates |
SHALL | source-reference | reference | Allows including the document that contains the PDF or similar representation of a paper consent |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve a Device that is the requester or intended performer of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved Devices that are the requester or intended performer of ServiceRequests.
Used to retrieve the requester or intended performer of an SDOH ServiceRequest. Note: Conformance expectations for this resource are lower because Device requesters and performers are expected to be uncommon in most SDOH uses
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Device records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve a PDF or similar content referenced by a Consent or Task.
search-type
Allows the monitoring of previously-retrieved DocumentReferences in the event the image/document is amended/corrected/updated.
Used to retrieve a scanned or other form of document representing the text of a consent. Also used for PDF forms.
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known DocumentReference records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve a goal referenced by a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved Goals in the event they are updated.
Used to access goals related to an SDOH referral
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Goal records - and more specifically, retrieving more than one in a single call to poll for updates |
SHALL | category | token | Allows filtering to only include SDOH-related goals |
SHALL | patient | reference | Allows filtering to only include goals for a particular patient. Some systems will require searches to be patient-specific |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
SHOULD | achievement-status | token | Allows filtering to only include unmet goals |
SHOULD | lifecycle-status | token | Allows filtering to only include active goals |
SHOULD | target-date | date | Allows filtering based on when a particular goal is desired to be achieved |
literal
read
Allows the system to retrieve a HealthcareService that is the intended performer of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved HealthcareServices that are the intended performer of ServiceRequests.
For referral sources that receive referrals from upstream systems, used to access information about the intended performer of a ServiceRequest when the performer is a specific service within a larger facility. Also used to indicate who a patient or caregiver should contact about a particular service.
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known HealthcareService records - and more specifically, retrieving more than one in a single call to poll for updates |
SHALL | location | reference | Allows retrieval of the phyical site(s) associated with a HealthService |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve a Location that is an available location for a service.
search-type
Allows the monitoring of previously-retrieved Locations that are the intended locations for services.
Used to access information about the potential sites at which a requested service might be performed. Allows a patient to evaluate the suitability of a proposed activity or service.
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Location records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve an Observation referenced by a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved Observations for updates/corrections.
SDOHCC Observation Assessment
SDOHCC Observation Screening Response
SDOHCC Observation Ethnicity OMB
SDOHCC Observation Race OMB
SDOHCC Observation Gender Identity
SDOHCC Observation Personal Characteristic
SDOHCC Observation Personal Pronouns
SDOHCC Observation Recorded Sex Gender
SDOHCC Observation Sexual Orientation
For referral sources that receive referrals from upstream systems, used to access information about SDOH-related observations for a patient - particularly those that are reasons for a referral as well as certain SDOH-relevant demographic information
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Observation records - and more specifically, retrieving more than one in a single call to poll for updates |
SHALL | category | token | Allows filtering for only SDOH-related observations |
SHALL | patient | reference | Allows filtering for observations specific to a particular patient. Some systems will require that all queries be patient-specific |
SHALL | status | token | Allows filtering for observations that are completed or revised (i.e. not in-progress or entered-in-error) |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
SHOULD | code | token | Allows filtering for specific types of observations |
SHOULD | date | date | Allows filtering for observations that held in a particular time period |
SHOULD | derived-from | reference | Allows filtering for observations derived from a particular QuestionnaireResponse |
MAY | code-value-concept | composite | Allows filtering for observations that have a specific coded value answer for a specified observation type |
literal
read
Allows the system to retrieve an Organization that is the requester or intended performer of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved Organizations that are the requester or intended performer of ServiceRequests.
For referral sources that receive referrals from upstream systems, used to access information about an Organization that is the requester or intended performer of a ServiceRequest
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Organization records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve the Patient that is the subject of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved Patients.
For referral sources that receive referrals from upstream systems, used to access information about the Patient that is the subject a ServiceRequest
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Patient records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve a Practitioner that is the requester or intended performer of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved Practitioners that are the requester or intended performer of ServiceRequests.
For referral sources that receive referrals from upstream systems, used to access information about an Practitioner that is the requester or intended performer of a ServiceRequest
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Practitioner records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows the system to retrieve a PractitionerRole that is the requester or intended performer of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved PractitionerRoles that are the requester or intended performer of ServiceRequests.
For referral sources that receive referrals from upstream systems, used to access information about an PractitionerRole that is the requester or intended performer of a ServiceRequest
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known PractitionerRole records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
SHOULD | organization | reference | Allows doing an _include on Organization when retrieving the PractitionerRole |
SHOULD | practitioner | reference | Allows doing an _include on Practitioner when retrieving the PractitionerRole |
literal
create
Allows the system to write records of procedures done in response to a referral on the system that asked for the referral.
update
Allows the system to update records of procedures done in response to a referral on the system that asked for the referral.
read
Allows the referral recipient to retrieve procedures referenced by Tasks previously posted.
search-type
Allows the referral recipient to check if others have updated (e.g. added comments) to procedures previously posted and/or to find previously submitted procedures so they can be rendered to a user.
Used to record information about actions that have been performed as a result of a referral
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Procedure records - and more specifically, retrieving more than one in a single call to poll for updates |
SHALL | based-on | reference | Allows filtering for procedures resulting from a particular service request |
SHALL | category | token | Allows filtering for procedures that are SDOH-related |
SHALL | patient | reference | Allows filtering for procedures based on who they were delivered to. Some systems may require that all searches be patient-specific. |
SHALL | performer | reference | Allows filtering for procedures based on who delivered the procedure. |
SHALL | status | token | Allows filtering for procedures that are complete or in progress |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
SHOULD | code | token | Allows filtering for procedures based on the specific service delivered |
SHOULD | date | date | Allows filtering for procedures based on when they were delivered |
literal
read
Allows the system to retrieve a RelatedPerson that is the requester or intended performer of a ServiceRequest.
search-type
Allows the monitoring of previously-retrieved RelatedPersons that are the requester or intended performer of ServiceRequests.
For referral sources that receive referrals from upstream systems, used to access information about the requester or intended performer of a ServiceRequest when they are someone with a personal relationship to the Patient. Note: Conformance expectations for this resource are lower because CareTeam performers are expected to be uncommon in most SDOH uses
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known RelatedPerson records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literal
read
Allows client systems to retrieve the ServiceRequest pointed to by a Task.
search-type
Allows client systems to monitor multiple ServiceRequests for change simultaneously via polling.
For referral sources that receive referrals from upstream systems, used to retrieve an order for SDOH-related services
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known ServiceRequests records - and more specifically, retrieving more than one in a single call to poll for updates |
SHALL | category | token | Allows filtering to only retrieve ServiceRequests that are SDOH-related |
SHALL | intent | token | Allows filtering to retrieve only 'order' ServiceRequests and not plans, proposals, etc. |
SHALL | patient | reference | Allows filtering to retrieve only ServiceRequests associated with a particular patient. Note that some systems may mandate that searches are always patient-specific |
SHALL | status | token | Allows filtering to retrieve only active ServiceRequests |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
SHOULD | code | token | Allows filtering to retrieve ServiceRequests for specific types of services |
SHOULD | occurrence | date | Allows filtering to retrieve ServiceRequests based on the timeframe in which the service needs to be provided |
SHOULD | performer | reference | Allows filtering to retrieve only ServiceRequests that designate a specific performer |
SHOULD | requester | reference | Allows filtering to retrieve only ServiceRequests created by a specific practitioner |
SHOULD | supporting-info | reference | Allows _include to retrieve supporting information for a ServiceRequest - particularly Consent |
create
Necessary if using subscriptions to monitor updates to the Task
update
Needed to allow the requester to update a subscription - to adjust delivery target, to add additional tasks to monitor (if subscribing by id) typically to cancel a request for fulfillment
Used to allow upstream systems to subscribe to and monitor Tasks stored on this system for change
Conformance | Operation | Documentation |
---|---|---|
SHOULD | $status | Necessary for systems supporting subscriptions to ensure that the subscription is functioning properly and to check for errors |
server
The clinical care referral recipient needs to allow SDOH clinical care referral sources and coordination platforms to have solicited the filling of SDOH-related referrals by this system and also to access Procedures that describe interventions taken by the users of this system.
SMART-on-FHIR
Implementations must meet the general privacy & security requirements documented in this implementation guide.
batch
interaction described as follows:Allows other systems to poll for changes to multiple resource types simultaneously
The summary table lists the resources that are part of this configuration, and for each resource it lists:
_include
_revinclude
Resource Type | Profile | R | S | U | C | Searches | _include | _revinclude | Operations |
---|---|---|---|---|---|---|---|---|---|
DocumentReference | Supported Profiles US Core DocumentReference Profile | y | y | y | y | _id, _lastUpdated | |||
Subscription | Supported Profiles R4/B Topic-Based Subscription | y | y | $status | |||||
Task | Supported Profiles SDOHCC Task For Patient SDOHCC Task For Referral Management | y | y | y | y | _id, _lastUpdated, code, owner, patient, requester, status, focus, output | Task:output |
literal
create
Allows the app to record a new PDF (e.g. a completed form)
read
Allows patient apps to retrieve a PDF or similar content referenced by a Consent or Task.
search-type
Allows patient apps to monitor previously-retrieved DocumentReferences in the event the image/document is amended/corrected/updated.
update
Allows the system to revise a previously stored PDF
Used convey a scanned or other form of document representing the text of a consent. Also used for PDF forms.
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known DocumentReference records - and more specifically, retrieving more than one in a single call to poll for updates |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
create
Allows upstream systems to initiate a subscription to monitor updates to Tasks (and theoretically other things)
update
Allows upstream systems to revise existing subscriptions - to adjust delivery target, to add additional tasks to monitor (if subscribing by id), etc.
Used to allow upstream coordination platforms and referral sources to subscribe to and monitor Tasks created on this system
Conformance | Operation | Documentation |
---|---|---|
SHOULD | $status | Allows upstream systems to verify their subscription is functioning properly and to check for errors |
literal
create
Allows upstream coordination platforms and referral sources system to create tasks on this system seeking fulfillment of a ServiceRequest or requesting that a patient or caregiver perform certain activities.
update
Allows modification of an existing Task by upstream systems (e.g. to cancel it) or by downstream systems (to accept or reject it or add output links to performed procedures). ReferralRecipients can freely modify any Tasks they have created (though they should consider the impact of doing so on downstream recipients or the patient). However, if they are not the creator, they SHALL only modify tasks they are the 'owner' of and then, only modify Task.status, Task.statusReason, and Task.outputs are possible, and then only for Tasks where the owner is the patient.
read
Allows retrieval of a Task that was referenced in a subscription notification or per-Task polling for change.
search-type
Allows the other systems to poll multiple tasks simultaneously, as well as to retrieve referenced resources as part of a single query.
Used by upstream referral sources and coordination platforms to create and update Tasks seeking fufillment of ServiceRequests. Also used by downstream referral recipiencts to monitor and update Tasks stored on this system as they respond to requests to fulfill referrals and link in information about actions taken so far
Conformance | Parameter | Type | Documentation |
---|---|---|---|
SHALL | _id | token | Allows retrieving known Task records - and more specifically, retrieving more than one in a single call to poll for updates |
SHALL | code | token | Allows filtering for 'fulfill' tasks as opposed to others. Some systems may require code to be included as a filter criteria as different Task codes may correspond to different internal database tables. |
SHALL | patient | reference | Allows monitoring of tasks associated with a particular patient. (Some systems may require that all queries be done in the context of a single patient.) |
SHALL | requester | reference | Allows retrieving all tasks that have been requested by a particular organization or individual. This will commonly be used to monitor the tasks initiated by a particular system |
SHALL | status | token | Allows filtering to only active or completed tasks |
SHALL | focus | reference | Allows retrieving the task(s) seeking fulfillment of a particular ServiceRequest |
SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
SHOULD | owner | reference | Allows filtering only for tasks that are assigned to a particular owner (or alternatively, tasks that have not yet been assigned) |
SHOULD | output | reference | Allows for the 'output' of a Task to be included when retrieving a Task |