Discussion on updates for the Interoperability Standards Advisory (ISA):

  • Currently 360X is under
    • Section II: Content/Structure Standards and Implementation Specifications
      • Summary Care Record
        • Support a Transition of Care or Referral to Another Healthcare Provider
  • We need a better presentation. We will propose the following:
    • Under section II create a new sub-section, called "Care coordination for referrals"
    • Within that, list three sub-sections:

      • Closed Loop Referral to Specialist

      • Referral from Acute Care to SNF

      • Closed Loop Referral to Extra-Clinical Services

Discussion on proper handling of clinical data after a decline

  • The 360X Implementation guide doesn't say anything, but in demos it is emphasized that after a decline the clinical information is removed from the recipient's system
  • The IG doesn't specify anything on that, because it is specific to different situations. If the patient had not been seen by the recipient before the request, then it is up to local or jurisdictional policies what to do with the clinical data. The ability to purge data in this case is a system feature, but no general requirement can be made
  • There are cases when it is against  local or jurisdictional policies to purge the clinical data after a decline. In the case of SNFs, the information is needed to justify the decline in the case of an audit.
  • Probably needs clarification/short discussion in the IG.

Question about where the reason for cancel is located - it is in ORC-16

A request for sample 360X messages

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