The existing eMeasure specification standard categories and data types do not provide a clear method of representing a referral request that was received by a particular provider and distinguishing it from a referral request that is initiated by the same provider.

Currently Proposed Solution

The currently proposed solution uses a "direction" attribute that can that can take a "received" or "sent" code as its value. For example:

Intervention, Order: Referral (direction: 'received')

This would indicate the referral was received by the practice / organization being measured. If metrics for individual physicians are preferred, the measure could likely be stratified by physician.

Previously Proposed Solution

The previously proposed solution used sent/received attributes that could take a boolean and be filtered on. For example:

Intervention, Order: Referral (received: true)

While this solution could work, it requires multiple attributes and isn't as clear as the currently proposed solution.

We are currently working to identify the best way to represent this in HQMF and QRDA Cat I.