Question: v2 Referrals
Jun 18, 2014Question:
A typical scenario of tele-consultation is as follows. A patient comes to his nearest hospital. He is assigned to an initially assigned physician (IAP). All the relevant medical information are collected. IAP wants to consult with a specialist physician from a different hospital. So he sends the patient records to the referred hospital.
I assume hospitals are equipped with these EMR systems and they communicate via HL7 V2 messages. How patient medical records can be sent to the referred EMR? Which event to be triggered? What should be the message type? I could not find any HL7v2 message type that could hold all kind of patient records. How to handle such a situation with HL7v2? CDA has that capability. Many revisions are done for HL7v2. Is that already addressed?
Answer
The message type you are looking for is a referral - the IAP is referring the patient to the specialist. Note that some clinicians use the word “referral” strictly in the sense of a full transfer of care, not just a consultation, while others use the term more loosely. The HL7 referral message is suitable for both uses.
The message you are looking for is an REF/RRI message (event I12, chapter 11). It includes the following kinds of information:
- Referral details
- Contact and Provider information
- Observations, and Diagnostic reports
- Procedures, Problem lists, Allergy Lists
- Encounter details
Alternatively, there’s the MDM messages in chapter 9 that deal with transfer of medical records - though they leave open the question of what format to use. In your use case, the natural choice would be CDA as the format, but if you want to avoid that, well, you come back to the REF message.