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<div class="clr-fig-caption">Fig. 4.2: 360X State Diagram, Initiator's Point of View</div><div class="clr-src-file"><a target="_blank" href="https://oncprojectracking.healthit.gov/wiki/download/attachments/18776115/360X_State_Diagram_SPOV_20160824.vsd?api=v2">Source</a></div> |
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<div class="clr-fig-caption">Fig. 4.3: 360X State Diagram, Recipient's Point of View</div> <div class="clr-src-file"><a target="_blank" href="https://oncprojectracking.healthit.gov/wiki/download/attachments/18776115/360X_State_Diagram_RPOV_20160824.vsd?api=v2">Source</a></div> |
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The referral recipient SHALL provide the Referral Initiator a Result of the care provided. The Result MUST be sent via the mechanism(s) set forth by the 360X Transport Protocol and MUST contain the content specified by the Referral Summary Payload specification.
Narrative description:
If the Result of Referral is sent in an eCQM-enabled environment where the Closing the Referral Loop measure CMS50vN is being tracked, at least one of the SNOMED CT codes from value set Consultant Report (2.16.840.1.113883.3.464.1003.121.12.1006), AND at least one of the SNOMED CT codes from value set Referral (2.16.840.1.113883.3.464.1003.101.12.1046) SHALL be sent in the eventCodeList attribute for the Document Entry representing the C-CDA in the Referral Summary Payload.
Narrative description:
After care has been provided, the referral recipient may create a record of the result of that care. The result may include a narrative conclusion of the care/patient condition, a diagnosis and/or any number of conclusionary and After care has been provided, the referral recipient may create a record of the result of that care. The result may include a narrative conclusion of the care/patient condition, a diagnosis and/or any number of conclusionary and related health information such as an updated patient problem list, new or revised medications, new or revised record of allergies, new or revised patient instructions, new or revised plan for ongoing care, diagnostic tests performed and their result values, diagnostic images, etc. Any or all of this information may be relevant to the Referral Initiator. In context of this IG, electronic communication of the Result of Referral is required and supported by the transport and payload definitions.
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For a variety of clinical and administrative reasons (e.g., the patient is admitted to an inpatient care setting, the patient's insurance coverage changes, etc.), a Referral Initiator may choose to issue a cancellation request to a Referral Recipient for a specific referral. This request may be issued prior to or during an episode of care between the patient and Referral Recipient. Given the variability in timing and other circumstances, the Referral Recipient may decide to accept the cancellation request or may determine that he/she is unable to end the anticipated/ongoing episode of care for equally valid reasons, and complete the Episode of Care with a subsequent Result of Referral transaction.changes, etc.), a Referral Initiator may choose to issue a cancellation request to a Referral Recipient for a specific referral. This request may be issued prior to or during an episode of care between the patient and Referral Recipient. Given the variability in timing and other circumstances, the Referral Recipient may decide to accept the cancellation request or may determine that he/she is unable to end the anticipated/ongoing episode of care for equally valid reasons, and complete the Episode of Care with a subsequent Result of Referral transaction.
A Cancellation Confirmation or a Result of Referral ends that referral request.
4.3.6 Send Cancellation Confirmation
Functional requirements:
Upon receipt of a Cancellation Request from the Referral Initiator, the Referral Recipient MAY respond with a Cancellation Confirmation that signifies that the Referral Recipient will either not initiate or end the episode of care associated with this particular referral at the request of the Referral Initiator. The Cancellation Confirmation MUST be sent via the mechanism(s) set forth by the 360X Transport Protocol. The Cancellation Confirmation MUST contain the content specified by the Cancel Confirmation Payload.
Narrative description:
A Cancellation Confirmation ends this A Cancellation Confirmation or a Result of Referral ends that referral request.
4.3.
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7 Send Interim Consultation Note
Functional requirements:
Upon receipt of a Cancellation Request from the Referral InitiatorFollowing a patient encounter but prior to the end of an episode of care, the Referral Recipient MAY respond with a Cancellation Confirmation that signifies that the Referral Recipient will either not initiate or end the episode of care associated with this particular referral at the request of the Referral Initiator. The Cancellation Confirmation provide the Referral Initiator relevant health information about the patient such as a preliminary result or consultation notes. The Interim Consultation Note MUST be sent via the mechanism(s) set forth by the 360X Transport Protocol. The Cancellation Confirmation Interim Consultation Note MUST contain the content specified by the Cancel Confirmation Payload.
Narrative description:
A Cancellation Confirmation ends this referral request.
4.3.7 Send Interim Relevant Health Information
Functional requirements:
Following a patient encounter but prior to the end of an episode of care, the Referral Recipient MAY provide the Referral Initiator relevant health information about the patient such as a preliminary result or consultation notes. The Interim Consultation Note MUST be sent via the mechanism(s) set forth by the 360X Transport Protocol. The Interim Consultation Note MUST contain the content specified by Interim Consultation Note Payload. If the Interim Relevant Health Information is sent in an eCQM-enabled environment where the Closing the Referral Loop measure CMS50vN is being tracked, at least one of the SNOMED CT codes from value set Consultant Report (2.16.840.1.113883.3.464.1003.121.12.1006), AND at least one of the SNOMED CT codes from value set Referral (2.16.840.1.113883.3.464.1003.101.12.1046) SHALL be sent in the eventCodeList attribute for the Document Entry representing the C-CDA in the Interim Consultation Note Payload.
Narrative description:
In accordance with the Referral Recipient's clinical practices and office procedures, the Referral Recipient may provide one or more interim consultation notes during a patient’s episode of care to the Referral Initiator. This relevant patient information may inform the referral initiator about observations the provider has made, test results, preliminary findings, planned next steps, new problems found, medication changes, or any relevant information related to the referral request. Under this implementation guide, Referral Recipients are not required to send interim consultation reports. However, Referral Recipients are encouraged to utilize this functionality as dictated by standards of clinical practice, professional obligations, and/or to enhance the coordination of a patient’s care.
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