Bidirectional Services eReferrals (BSeR)

Bidirectional Services eReferrals involve the exchange of information between clinical care Electronic Health Records (EHRs) and service systems or EHRs that reside in services, lifestyle change, and public health organizations. They also involve the return of information from the services programs to clinical care.

Examples of these usually extra-clinical services programs include diabetes prevention, hypertension management, tobacco quit line, stroke management, arthritis management, obesity prevention, and other prevention and health promotion programs.

The standards developed through this project will:

- help raise the visibility and accessibility of available service programs in clinical workflow;

- facilitate clinician and case manager referral initiation in clinical care;

- support the consent, approvals, and scheduling processes;

- provide appropriate common and program specific patient data in the referral itself; and

- support engagement, progress, and achievement updates being sent back from the services program to the clinical referrer.

This project will develop the data requirement specifications for: 1) common patient referral data, 2) program specific patient referral data, 3) patient status data to return to clinical care from the services programs, and 4) the types of transactions needed to support. It will develop full specifications and transactions in FHIR and consider CDA data specifications built from C-CDA templates. A common logical model will be used for both. Extant version 2 and version 3 relevant work will be considered also moving forward. The project may include two US Realm STU implementation guides - one in FHIR and one in CDA.

Products will build off of developing FHIR referral resources and transactions, but in the context of inter-organizational exchange constraints and services programs that are not always provided by HIPAA covered entities or Business Associates. The project will perform an environmental scan to evaluate existing referral mechanisms and work with Patient Care to avoid re-work and any confusion in the implementation community.