EHRS-FM IG

ISO/HL7 10781 - Electronic Health Record System Functional Model, Release 2.1
0.16.0 - CI Build

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

Active as of 2024-08-12
Statement N:

Evaluate referrals within the context of a patient's healthcare data.

 Description I:

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.

 Criteria N:
CPS.4.6.1#01 SHALL

The system SHALL provide the ability to capture and render clinical and administrative data (e.g., insurance information) as part of the referral process.
CPS.4.6.1#02 SHOULD

The system SHOULD provide the ability to capture and render test and procedure results with a referral.
CPS.4.6.1#03 MAY

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.
CPS.4.6.1#04 SHALL

The system SHALL provide the ability to render clinical and administrative data, as well as test and procedure results to the referred-to provider.
CPS.4.6.1#05 SHALL

The system SHALL provide the ability to capture and render referral orders with detail adequate for correct routing to the referred-to provider.
CPS.4.6.1#06 SHOULD

The system SHOULD provide the ability to transmit clinical and administrative data, as well as test and procedure results to the referred-to provider.
CPS.4.6.1#07 dependent SHALL

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).
CPS.4.6.1#08 SHOULD

The system SHOULD provide the ability to capture a provider's schedule for receiving referrals.
CPS.4.6.1#09 conditional SHOULD

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.
CPS.4.6.1#10 MAY

The system MAY provide the ability to transmit a referral to multiple providers.