Welcome to 360X: Closed Loop Referrals Project

360X was launched in 2012, as part of ONC's State Health Information Exchange Cooperative Agreement Program.  The original goal was to significantly improve the patient referral process  for patients, their designated caregivers, providers and staff from the initial referral order to the referring provider receiving the final consultation note from the specialist, thereby closing the referral loop.  The 360X IHE approved Standard uses proven, ubiquitously adopted technology to achieve the interoperability goals initially of Meaningful Use Stage 2, and now of the Merit Based Incentive Payment System (MIPS) to enable seamless interoperable provider exchange of patient information for referrals from their EHR workflow, regardless of the EHR systems and/or Health Information Service Providers (HISP) services used (i.e., allowing information to move point-to-point between unaffiliated organizations, differing EHRs, and differing HISPs) with at least the same quality of workflow integration providers currently experience when referring between homogeneous EHR systems. While the State HIE Program closed out programmatic activities in 2014, 360X remains active under ONC’s Office of Standards and Technology, and Tech Lab. 

The original use case of the closed loop referral is now an IHE approved protocol.  In addition, the group has completed, and IHE has approved, the use case of  patient transfers from acute facilities to skilled nursing facilities (SNFs).  The group is now focused on the pandemic relevant use cases of transfers from SNFs to acute emergency departments (EDs), Social Determinants of Health (SDOH) needs based referrals and eConsults (a provider asking a specialist provider a question regarding a specific patient without, at least initially, referring the patient to the specialist). 

360X (closed loop referral) and 360XL (acute to SNF transfer) are IHE approved protocols and will be piloted in 2021.  The other use cases are under development.

To join the project group, contribute to improving the specification, defining the new use cases or get implementation questions answered, please contact Brett Andriesen.

You can join the contributor mailing list by sending an e-mail to 360x-contrib-join@360x-referral.com from you preferred e-mail account. Please make sure that an overzealous spam filter is not holding any responses to your subscription request.