Referral

Starting a referral

The most popular use case where ZorgDomein Integrator is used is the referral. When doing a referral, the referrer logs in to ZorgDomein directly from his/her own information system using SSO. After logging in, he/she will select a healthcare product that is published by a specific healthcare supplier. This determines the choice for the healthcare supplier to which the patient will be referred. Once the healthcare supplier has been selected, the referrer will compose and send the following documents to the selected healthcare supplier:

Appointment request: a logistic message that announces the referral and contains the logistic data of the referral, i.e. details of the patient, referrer, referring organization, recipient and selected healthcare request.
Referral letter with optional attachments. The content of this referral letter is automatically composed based on medical patient data from the information system of the referrer.

A copy of both documents will be sent back to the information system of ther referrer for archiving purposes.

Please note that these two documents are not sent at the same time. The appointment request is sent as soon as the referrer has confirmed his/her choice for a healthcare product belonging to a healthare supplier. At this point the healthcare supplier is informed about the referral. The referrer may choose to compose and send the referral letter at a later point in time.

Sending a supplement

After sending the referral letter, the referrer may sooner or later decide to send one or more supplemental documents. The referrer may optionally add one or more attachments to the supplemental letter. A copy of the supplemental document will be sent back to the information system of the referrer.

Cancelling a referral

As soon as the referral has started (i.e. when the appointment request has been sent), the referrer may choose to cancel the referral by sending a cancellation message to the selected healthcare supplier. A copy of the cancellation message will be sent back to the information system of the referrer.

Reporting back to the referrer

When a healthcare supplier has received the referral, a practitioner can respond to the referral by sending a report back to the referrer. The practitioner starts this report from his/her information system by logging in to ZorgDomein using SSO. After logging in, he/she will be directed to the report form that can be used to compose a report. The content of this report is automatically composed as much as possible based on medical patient data from the information system of the practitioner. The practitioner may also add attachments to the report form. These attachments should be fetched from the information system of the practitioner. After submitting the report form, ZorgDomein will deliver the report document to the information system of the referrer. A copy of the report will be sent back to the information system of the practitioner.

Sequence diagram

The sequence diagram below provides a schematic overview of all interactions between the involved actors when performing a referral.

Referrer

ZorgDomein

Provider

Send referral

Sign on and get application context

SSO call to ZorgDomein

The SSO call to ZorgDomein consists of a HTTP GET request to the JWT login endpoint of ZorgDomein. In this request a valid SSO token (JWT) must be provided as query parameter. See SSO to ZorgDomein for more details.

Request application context details

The SSO token must contain the ID of a FHIR Task resource in the context.xis-transaction-id claim of the SSO token. ZorgDomein will request that Task resource to request additional patient context details. See SSO to ZorgDomein for more details.

Serve application context details

The FHIR server is expected to provide the requested Task, Patient and Coverage resources.

Send appointment request

After a healthcare product has been selected by the referrer, ZorgDomein will send an appoint request to the selected recipient. This appointment request is presented at the receiving system as a FHIR Document of type “Afspraakbericht”. See Receive documents for more details.

Send copy of appointment request

A copy of the appointment request that was sent to the recipient will also be sent to the system of the referrer. This appointment request is presented at the sending system as a FHIR Document of type “Afspraakbericht”, and should be saved as outbound correspondence for the patient. See Send documents for more details.

Compose and send referral letter

Request medical patient datarepeatable

Request medical patient data

Based on the selected healthcare product, ZorgDomein will request medical details that are relevant for the healthcare product at the sending system. This is established by a series of FHIR search requests at several FHIR endpoints. See Send documents for a list of supported FHIR resources and corresponding fields in the referral letter.

Serve medical patient data

The FHIR server of the sending system is expected to answer all requested FHIR resources, for as far as the requested data can be provided by the sending system. If the requested data cannot be provided by the sending system, it should respond with either an empty FHIR search set, or with HTTP 404.

Add attachmentsrepeatable

Query list of attachments

When the referrer wants to add one or more attachments to the referral letter, ZorgDomein will first query a list of potentially relevant attachments by sending a FHIR search query to the DocumentReference endpoint of the sending system. See Adding attachments to documents for more details.

Serve list of attachments

The FHIR server of the sending system is expected to serve a FHIR search set that represents a list of the relevant documents that may be added to the referral letter in ZorgDomein.

Query binary data

After the relevant documents have been selected, ZorgDomein will query the actual binary data of the documents. See Adding attachments to documents for more details.

Serve binary data

The FHIR server of the sending system is expected to serve the requested binary data.

Send referral letter

After a referral letter has been submitted by the referrer, ZorgDomein will send the referral letter to the receiving system as a FHIR Document of type “Verwijsbrief”. See Receive documents for more details.

Send attachments

When the referrer has added one or more attachments to the referral letter, these attachments will be sent to the receiving system in a separate FHIR Document.

Send copy of referral letter

A copy of the referral letter that was sent to the recipient will also be sent to the system of the referrer. This referral letter is presented at the sending system as a FHIR Document of type “Verwijsbrief”, and should be saved as outbound correspondence for the patient. See Send documents for more details.

Send supplement

Add attachmentsrepeatable

Query list of attachments

When the referrer wants to add one or more attachments to the supplement, ZorgDomein will first query a list of potentially relevant attachments by sending a FHIR search query to the DocumentReference endpoint of the sending system. See Adding attachments to documents for more details.

Serve list of attachments

The FHIR server of the sending system is expected to serve a FHIR search set that represents a list of the relevant documents that may be added to the supplement in ZorgDomein.

Query binary data

After the relevant documents have been selected, ZorgDomein will query the actual binary data of the documents. See Adding attachments to documents for more details.

Serve binary data

The FHIR server of the sending system is expected to serve the requested binary data.

Send supplement

After a supplement has been submitted by the referrer, ZorgDomein will send the supplement to the receiving system as a FHIR Document of type “Nazending”. See Receive documents for more details.

Send attachments

When the referrer has added one or more attachments to the supplement, these attachments will be sent to the receiving system in a separate FHIR Document.

Send copy of supplement

A copy of the supplement that was sent to the recipient will also be sent to the system of the referrer. This supplement is presented at the sending system as a FHIR Document of type “Nazending”, and should be saved as outbound correspondence for the patient. See Send documents for more details.

Send cancellation

Send cancellation request

When the referrer cancels a referral, ZorgDomein will send a cancellation request to the recipient. This cancellation request is presented at the receiving system as a FHIR Document of type “Annuleringsbericht”. See Receive documents for more details.

Update FHIR Task status

The FHIR Task resource that was provided to ZorgDomein during SSO (for the initial submission of the referral) is updated at the source system using a FHIR update (HTTP PUT) request. The body of the request will contain the original content of the Task resource, where Task.status is set to cancelled.

Send copy of cancellation request

A copy of the cancellation request that was sent to the recipient will also be sent to the system of the referrer. This cancellation request is presented at the sending system as a FHIR Document of type “Annuleringsbericht”, and should be saved as outbound correspondence for the patient. See Send documents for more details.

Send report

Sign on and get application context

SSO call to ZorgDomein

The SSO call to ZorgDomein consists of a HTTP GET request to the JWT login endpoint of ZorgDomein. In this request a valid SSO token (JWT) must be provided as query parameter. See SSO to ZorgDomein for more details.

Request application context details

The SSO token must contain the ID of a FHIR Task resource in the context.xis-transaction-id claim of the SSO token. ZorgDomein will request that Task resource to request additional context details. See SSO to ZorgDomein for more details.

Serve application context details

The FHIR server is expected to provide the requested Task resource. This Task resource must contain the ZD-number of the referral for which a report will be sent in Task.basedOn.identifier.

Compose and send report

Request medical patient datarepeatable

Request medical patient data

Based on the template of the report, ZorgDomein will request the relevant medical details at the sending system. This is established by a series of FHIR search requests at several FHIR endpoints of the sending system. See Send documents for a list of supported FHIR resources and corresponding fields in the referral letter.

Serve medical patient data

The FHIR server of the sending system is expected to provide all requested FHIR resources, for as far as the requested data can be provided by the system sending. If the requested data is not available, the sending system should respond with either an empty FHIR search set, or with HTTP 404.

Add attachmentsrepeatable

Query list of attachments

When the sender of the report wants to add one or more attachments to the report, ZorgDomein will first query a list of potentially relevant attachments by sending a FHIR search query to the DocumentReference endpoint of the sending system. See Adding attachments to documents for more details.

Serve list of attachments

The FHIR server of the sending system is expected to serve a FHIR search set that represents a list of the relevant documents that may be added to the supplement in ZorgDomein.

Query binary data

After the relevant documents have been selected, ZorgDomein will query the actual binary data of the documents. See Adding attachments to documents for more details.

Serve binary data

The FHIR server of the sending system is expected to serve the requested binary data.

Send report

After a report has been submitted by the sender of the report, ZorgDomein will send the report to the receiving system as a FHIR Document. See Receive documents for more details.

Send attachments

When the referrer has added one or more attachments to the report, these attachments will be sent to the receiving system in a separate FHIR Document.

Send copy of report

A copy of the report that was sent to the recipient will also be sent to the system of the sender of the report. This report is presented at the sending system as a FHIR Document, and should be saved as outbound correspondence for the patient. See Send documents for more details.

Referral

Starting a referral

Sending a supplement

Cancelling a referral

Reporting back to the referrer

Sequence diagram

Questions or comments?

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