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24 
AttributePurpose within 360XRequired (Source of Requirement)Corresponding HL7 Field/Component/Subcomponent
authorIf supplied, MUST indicate the document's (order) author, which may be different from the message sender. For the order, this is the clinician who is requesting the referral.>R2
(XDR and XDM for Direct Messaging)		Ordering Provider in ORC-12
classCodeIdentifies the specific document type, in this case an HL7 V2 Order.
See also typeCode which further refines the class definition and should not be ambiguous		R
(360X)
(R2 XDR and XDM for Direct Messaging)		Message Type in MSH-9.1 (OMG)
confidentialityCodeIdentifies the confidentiality defined for the order.
Implementations SHOULD NOT use codes that reveal the specific trigger causes of confidentiality (e.g., ETH, HIV, PSY, SDV)		R2
(XDR and XDM for Direct Messaging)		Confidentiality Code in ORC-28
Implementations SHOULD constrain to values that do not reflect the cause of confidentiality such as:
V Very restricted
R Restricted
U Usual control
creationTimeDefines the creation time of the message (vs. the order)R2
(XDR and XDM for Direct Messaging)		Date/Time of Message in MSH-7
entryUUIDThe identifier used for referencing the Document Entry object within the metadataR
(XDR and XDM for Direct Messaging)		N/A

eventCodeListThis list of codes represents the main clinical acts which does not conflict with the class and type codes. In this case, extends the document type (classCode=OMG, type=O19) to define the specific service requested.O
(IHE XDR)		Universal Service Identifier in OBR-4, CWE_2.1
Where XDR classification scheme is name of coding system in CWE_2.3
formatCodeGlobally unique identifier specifying the format of the document (referral request/order) to allow systems to determine if / how to process. 
For 360X can be formed from 
MSH-9 Message Type
MSH-12 Version ID
MSH-21 MessageProfileIdentifier		R
(360X)		OMG^O19_2.5.1_360XReferralRequest
healthcareFacilityTypeCodeSee also practice setting type. This code represents the type of organizational setting of the clinical encounter during which the documented act occurred. Note that in context of 360X, this is the facility type of the Referral Request Initiator.R2
(XDR and XDM for Direct)		Should be derived from / mapped to the information in ORC-21 through  24  
languageCodeSpecifies the language of the document (order / referral request)R2
(XDR and XDM for Direct)		Principal Language of Message in MSH-19
mimeTypeThe MIME type of the documentR 
(XDR and XDM for Direct Messaging)		x-application/hl7-v2+er7
patientIdSee also sourcePatientID.
patient ID MUST be the same as the patientID in the submission set (which, not does not include the sourcePatientID) and all document entries.
Per IHE, is the ID as known to the referral request recipient / target document registry, if known. 		R2
(360X)
(R2 XDR and XDM for Direct Messaging)		The patientID in context of the message recipient (referral request recipient), if known, from the PID-3 list in the order.
Referral request acceptance/responses will include a sourcePatientID (ID in context of referral request recipient) which the initiator shall use as patientID in subsequent transactions to aid in matching.
sourcePatientIdSee also Patient ID.
The sourcePatientID is the ID as known by the document submitter (in this case, the referral request initiator). This ID Shall be the same as that for the C-CDA document meta data.		R
(360X)		The patient ID in the PID-3 list that represents the referral request initiator’s patient ID.
sourcePatientInfoRelevant patient demographics such as last name, first name, sex, DOB that may help in matching (electronically or by a person) if IDs are insufficient.R2 per XDR, O per IHE??PID-5, PID-7, PID-8 content should be used.
practiceSettingCodeIdentifies the setting that created the order at a high granularity e.g., Cardiology, FamilyPractice. Should not create ambiguity as compared to healthcareFacilityTypeCode.R2
(XDR and XDM for Direct)		Should be derived from/mapped to the information in ORC-21 through 24
typeCodeFurther refines classCode and should not make ambiguous. Defines the specific HL7 V2 message event type, for this message it is O19R
(360X)		MSH-9.2^9.3
OMG^O19^OMG_O19
uniqueIdGlobally unique identifier assigned to the document by its creator.R
(XDR and XDM for Direct Messaging)		May be based on Message Control ID in MSH-10

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AttributePurpose within 360XRequired (Source of Requirement)Corresponding C-CDA element
authorIf supplied, MUST indicate the document's author, which may be different from the message sender. For the order, this is the clinician who is requesting the referral.
Note that C-CDAs are often multi-authored and author may be defaulted in the document.		R2
(XDR and XDM for Direct Messaging)		Author entry in US Realm header.
classCodeIdentifies the specific document type, in this case a C-CDA template (e.g., CCD, SOEN, Referral Note).
See also typeCode which further refines the class definition and should not be ambiguous 		R
(360X)
(R2 XDR and XDM for Direct Messaging)		Type ID entry in US Realm header.
confidentialityCodeIdentifies the confidentiality defined for the document. 
Implementations SHOULD NOT use codes that reveal the specific trigger causes of confidentiality (e.g., ETH, HIV, PSY, SDV) 		R2
(XDR and XDM for Direct Messaging)		ConfidentialityCode in US Realm Header
creationTimeDefines the creation time of the document (vs. the message)R2
(XDR and XDM for Direct Messaging)		effectiveTime in US Realm Header
entryUUIDGlobally unique identifier UUID for the document as assigned by the message sender and used only in the XD* handling. R
(XDR and XDM for Direct Messaging)		N/A
eventCodeListContains a list of codes that reflect the clinical events occurring as the source of the information contained in the C-CDA documentR2 (360X)
O (IHE)		When the 360X transaction occurs in an environment tracking eCQM measure CMS50vN, the eventCodeList SHALL contain at least one at least one of the SNOMED CT codes from value set Consultant Report (2.16.840.1.113883.3.464.1003.121.12.1006)
formatCodeGlobally unique identifier specifying the format of the document to allow systems to determine if / how to process. R
(360X)		Per the C-CDA specificaiton
healthcareFacilityTypeCodeSee also practice setting type. This code represents the type of organizational setting of the clinical encounter during which the documented act occurred. Note that in context of 360X, this is the facility type of the Referral Request Initiator.R2
(XDR and XDM for Direct)		N/A
languageCodeSpecifies the language of the document (order / referral request)R2
(XDR and XDM for Direct)		languageCode of US Realm Header
mimeTypeThe MIME type of the documentR 
(XDR and XDM for Direct Messaging)		Currently the MIME type for CDA documents is simply "text/xml"
patientIdSee also sourcePatientId.
The patientId attribute MUST be the same as the patientId in the submission set, and all document entries.
Per IHE, it is the ID as known to the referral request initiator, and it MUST be the same as the sourcePatientId of the Referral Request that was sent by the referral initiator.		R
(360X)
(R2 XDR and XDM for Direct Messaging)		N/A
sourcePatientIdSee also Patient ID.
The sourcePatientID is the ID as known by the document submitter (in this case, the referral request recipient). This ID Shall be the same as that for the HL7v2 document entry meta data.		R2
(360X)		targetID in US Realm Header
sourcePatientInfoRelevant patient demographics such as last name, first name, sex, DOB that may help in matching (electronically or by a person) if IDs are insufficient.R2 per XDR, O per IHEElements in patient section of US Realm Header such as name, administrative sex, birth time, etc.
practiceSettingCodeIdentifies the setting that created the order at a high granularity e.g., Cardiology, FamilyPractice. Should not create ambiguity as compared to healthcareFacilityTypeCode.R2
(XDR and XDM for Direct)		Should be derived from/mapped to the information in ORC-21 through 24
typeCodeFurther refines classCode and should not make ambiguous. Defines the specific C-CDA document type such as
<code code="34133-9" displayName="Summarization of Episode Note" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />		R
(360X)		Code element from the US realm header
uniqueIdGlobally unique identifier assigned to the document by its creator.R
(XDR and XDM for Direct Messaging)		Id element (Globally unique identifier) in US realm header

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HTML
<div class="clr-fig-caption">Figure 7.8: 360X compliant transport protocol and referral summary payload</div>

7.7.2 MU2 Required Data Elements


7.7.3 XD Metadata RequirementsRequirements

7.7.3.1 Submission Set

7.7.3.2 Document Entry for HL7v2 Status Update message

7.7.3.3 Document Entry for C-CDA


The Document Entry metadata is usually derived from the C-CDA header, as shown in the table below:

AttributePurpose within 360XRequired (Source of Requirement)Corresponding C-CDA element
authorIf supplied, MUST indicate the document's author, which may be different from the message sender. For the order, this is the clinician who is requesting the referral.
Note that C-CDAs are often multi-authored and author may be defaulted in the document.		R2
(XDR and XDM for Direct Messaging)		Author entry in US Realm header.
classCodeIdentifies the specific document type, in this case a C-CDA template (e.g., CCD, SOEN, Referral Note).
See also typeCode which further refines the class definition and should not be ambiguous 		R
(360X)
(R2 XDR and XDM for Direct Messaging)		Type ID entry in US Realm header.
confidentialityCodeIdentifies the confidentiality defined for the document. 
Implementations SHOULD NOT use codes that reveal the specific trigger causes of confidentiality (e.g., ETH, HIV, PSY, SDV) 		R2
(XDR and XDM for Direct Messaging)		ConfidentialityCode in US Realm Header
creationTimeDefines the creation time of the document (vs. the message)R2
(XDR and XDM for Direct Messaging)		effectiveTime in US Realm Header
entryUUIDGlobally unique identifier UUID for the document as assigned by the message sender and used only in the XD* handling. R
(XDR and XDM for Direct Messaging)		N/A
eventCodeListContains a list of codes that reflect the clinical events occurring as the source of the information contained in the C-CDA document

R2 (360X)

O (IHE)

When the 360X transaction occurs in an environment tracking eCQM measure CMS50vN, the eventCodeList SHALL contain at least one at least one of the SNOMED CT codes from value set Consultant Report (2.16.840.1.113883.3.464.1003.121.12.1006)
formatCodeGlobally unique identifier specifying the format of the document to allow systems to determine if / how to process. R
(360X)		Per the C-CDA specificaiton
healthcareFacilityTypeCodeSee also practice setting type. This code represents the type of organizational setting of the clinical encounter during which the documented act occurred. Note that in context of 360X, this is the facility type of the Referral Request Initiator.R2
(XDR and XDM for Direct)		N/A
languageCodeSpecifies the language of the document (order / referral request)R2
(XDR and XDM for Direct)		languageCode of US Realm Header
mimeTypeThe MIME type of the documentR 
(XDR and XDM for Direct Messaging)		Currently the MIME type for CDA documents is simply "text/xml"
patientIdSee also sourcePatientId.
The patientId attribute MUST be the same as the patientId in the submission set, and all document entries.
Per IHE, it is the ID as known to the referral request initiator, and it MUST be the same as the sourcePatientId of the Referral Request that was sent by the referral initiator.		R
(360X)
(R2 XDR and XDM for Direct Messaging)		N/A
sourcePatientIdSee also Patient ID.
The sourcePatientID is the ID as known by the document submitter (in this case, the referral request recipient). This ID Shall be the same as that for the HL7v2 document entry meta data.		R2
(360X)		targetID in US Realm Header
sourcePatientInfoRelevant patient demographics such as last name, first name, sex, DOB that may help in matching (electronically or by a person) if IDs are insufficient.R2 per XDR, O per IHEElements in patient section of US Realm Header such as name, administrative sex, birth time, etc.
practiceSettingCodeIdentifies the setting that created the order at a high granularity e.g., Cardiology, FamilyPractice. Should not create ambiguity as compared to healthcareFacilityTypeCode.R2
(XDR and XDM for Direct)		Should be derived from/mapped to the information in ORC-21 through 24
typeCodeFurther refines classCode and should not make ambiguous. Defines the specific C-CDA document type such as
<code code="34133-9" displayName="Summarization of Episode Note" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />		R
(360X)		Code element from the US realm header
uniqueIdGlobally unique identifier assigned to the document by its creator.R
(XDR and XDM for Direct Messaging)		Id element (Globally unique identifier) in US realm header


7.7.4 HL7 v2 Referral Summary object



Example:

Code Block
MSH|^~\&||^1.3.6.1.4.1.21367.2016.10.1.32^ISO||^1.3.6.1.4.1.21367.2016.10.1.21^ISO|20161012170822+0000||OSU^O51^OSU_O51|21882|P|2.5.1|||NE|NE|||||360X|
PID|1||T7190334^^^&1.3.6.1.4.1.21367.2016.10.1.21.5&ISO^MRN~L53HG67^^^&1.3.6.1.4.1.21367.2016.10.1.32.11&ISO^MRN||Packton^Peter^^^L||19580817|M|
ORC|SC|889342^^1.3.6.1.4.1.21367.2016.10.1.21.15^ISO|||CM||||||||

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