BSeR Referral Request Supporting Bundle

The Referral Request Supporting Bundle is a collection of relevant clinical items provided as supporting information for the referral request by the Referral Initiator. The clinical items included in an instance of this bundle vary by program area. The entries in this bundle are mutually exclusive program-specific clinical item bundles.

The base definition for this resource profile is the FHIR STU3 Bundle.

UML Expression

BSeR Referral Request Profile Bundles.jpg

Structure Definition Tree

type1..1
resource1..1Bundle
resource1..1Bundle
resource1..1Bundle
resource1..1Bundle
resource1..1Bundle
resource1..1Bundle

Profile Structure

Bundle..
Bundle.type1..1
Bundle.entry..
Bundle.entry1..1
Bundle.entry.resourceBundle1..1
Bundle.entry1..1
Bundle.entry.resourceBundle1..1
Bundle.entry1..1
Bundle.entry.resourceBundle1..1
Bundle.entry1..1
Bundle.entry.resourceBundle1..1
Bundle.entry1..1
Bundle.entry.resourceBundle1..1
Bundle.entry1..1
Bundle.entry.resourceBundle1..1

Example Referral Request Bundle

The following is an example of a rerral request bundle

<Bundle xmlns="http://hl7.org/fhir">
    <id value="DiabetesPreventionReferralRequestMessageBundle-A" />
    <meta>
        <versionId value="3" />
        <lastUpdated value="2019-01-12T17:49:02.000+00:00" />
        <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/DiabetesPreventionReferralRequestMessageBundle" />
    </meta>
    <type value="message" />
    <entry>
        <fullUrl value="urn:uuid:fc5857a1-98cb-4d3d-b6a0-fa0c18b3057d" />
        <resource>
            <MessageHeader>
                <!-- MessageHeaderInitiator -->
                <id value="fc5857a1-98cb-4d3d-b6a0-fa0c18b3057d" />
                <event>
                    <system value="http://terminology.hl7.org/CodeSystem/v2-0003" />
                    <code value="I12" />
                    <display value="Referral Request" />
                </event>
                <receiver>
                    <!-- PractitionerRole/ReferralRecipient goes directluy tp Practioner -->
                    <extension url="https://eip-fhir.experimental.aimsplatform.com/hapi-fhir/baseDstu3/StructureDefinition/Practioner-Role">
                        <valueReference>
                            <reference value="urn:uuid:ffa2bf53-ee09-43a1-b11a-73ed0f1cd73b" />
                        </valueReference>
                    </extension>
                    <reference value="urn:uuid:421269ad-abef-49bc-8cac-d3a5d4b00299" />
                </receiver>
                <sender>
                    <!-- PractitionerRole/ReferralInitiator -->
                    <extension url="https://eip-fhir.experimental.aimsplatform.com/hapi-fhir/baseDstu3/StructureDefinition/Practioner-Role">
                        <valueReference>
                            <reference value="urn:uuid:538791da-3555-460e-9e7f-76d25988a546" />
                        </valueReference>
                    </extension>
                    <reference value="urn:uuid:598af951-66e4-4910-a964-7e41533b183c" />
                </sender>
                <timestamp value="2018-12-11T05:05:11Z" />
                <source>
                    <name value="Centricity" />
                    <endpoint value="https://apisandbox.gehealthcare.com:9443/demoAPIServer" />
                </source>
                <reason>
                    <coding>
                        <system value="https://www.hl7.org/fhir/valueset-message-reason-encounter.html" />
                        <code value="class-enroll" />
                        <display value="Enroll in Class" />
                    </coding>
                </reason>
                <focus>
                    <!--  ReferralRequest1  -->
                    <reference value="urn:uuid:1b82e7bd-27bb-49bd-a404-0e5a7d2fa98c" />
                </focus>
            </MessageHeader>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:1b82e7bd-27bb-49bd-a404-0e5a7d2fa98c" />
        <resource>
            <ReferralRequest>
                <!--  ReferralRequest1  -->
                <id value="1b82e7bd-27bb-49bd-a404-0e5a7d2fa98c" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/BSeRReferralRequest" />
                </meta>
                <identifier>
                    <value value="71949668" />
                </identifier>
                <status value="active" />
                <intent value="order" />
                <serviceRequested>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="385804009" />
                        <display value="Diabetes care" />
                    </coding>
                </serviceRequested>
                <subject>
                    <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                </subject>
                <authoredOn value="2018-12-11" />
                <requester>
                    <agent>
                        <extension url="https://eip-fhir.experimental.aimsplatform.com/hapi-fhir/baseDstu3/StructureDefinition/Practioner-Role">
                            <valueReference>
                                <reference value="urn:uuid:538791da-3555-460e-9e7f-76d25988a546" />
                            </valueReference>
                        </extension>
                        <reference value="urn:uuid:598af951-66e4-4910-a964-7e41533b183c" />
                    </agent>
                </requester>
                <recipient>
                    <extension url="https://eip-fhir.experimental.aimsplatform.com/hapi-fhir/baseDstu3/StructureDefinition/Practioner-Role">
                        <valueReference>
                            <reference value="urn:uuid:ffa2bf53-ee09-43a1-b11a-73ed0f1cd73b" />
                        </valueReference>
                    </extension>
                    <reference value="urn:uuid:421269ad-abef-49bc-8cac-d3a5d4b00299" />
                </recipient>
                <reasonCode>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="15777000" />
                        <display value="Prediabetes" />
                    </coding>
                </reasonCode>
                <supportingInfo>
                    <!--  ReferralRequestSupportingBundle  -->
                    <reference value="urn:uuid:0bdbb1e5-5016-4291-8249-d16d8d07181f" />
                </supportingInfo>
                <supportingInfo>
                    <!--  ReferralRequestSupportingBundle  -->
                    <reference value="urn:uuid:29be9d88-0027-4f02-9b2c-f7a27aaaf10b" />
                </supportingInfo>
                <supportingInfo>
                    <!--  ReferralRequestSupportingBundle  -->
                    <reference value="urn:uuid:22449d51-3d71-49bd-a79a-c1f7557e09ef" />
                </supportingInfo>
            </ReferralRequest>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:ffa2bf53-ee09-43a1-b11a-73ed0f1cd73b" />
        <resource>
            <PractitionerRole>
                <!-- ReferralRecipient -->
                <id value="ffa2bf53-ee09-43a1-b11a-73ed0f1cd73b" />
                <practitioner>
                    <!--  Practitioner2  -->
                    <reference value="urn:uuid:421269ad-abef-49bc-8cac-d3a5d4b00299" />
                </practitioner>
                <organization>
                    <reference value="urn:uuid:f5db0002-3a69-472b-9263-be8d977fdaff" />
                </organization>
                <code>
                    <coding>
                        <system value="http://hl7.org/fhir/practitioner-role" />
                        <code value="doctor" />
                        <display value="Doctor" />
                    </coding>
                </code>
                <location>
                    <reference value="urn:uuid:17d9e3c9-a6a8-4550-b4db-d6f5a453d983" />
                </location>
            </PractitionerRole>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:538791da-3555-460e-9e7f-76d25988a546" />
        <resource>
            <PractitionerRole>
                <!--  ReferralInitiator  -->
                <id value="538791da-3555-460e-9e7f-76d25988a546" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/ReferralInitiatorPractitionerRole" />
                </meta>
                <practitioner>
                    <reference value="urn:uuid:598af951-66e4-4910-a964-7e41533b183c" />
                </practitioner>
                <organization>
                    <reference value="urn:uuid:e6d1abc8-595f-41ab-a6dc-13a034d3fac7" />
                </organization>
                <code>
                    <coding>
                        <system value="http://hl7.org/fhir/practitioner-role" />
                        <code value="doctor" />
                        <display value="Doctor" />
                    </coding>
                </code>
                <location>
                    <!--  urn:uuid:ServiceDeliveryLocationInitiator -->
                    <reference value="urn:uuid:25fa3dbc-dc9e-42c2-b681-0352765645af" />
                </location>
            </PractitionerRole>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:421269ad-abef-49bc-8cac-d3a5d4b00299" />
        <resource>
            <Practitioner>
                <!--  Practitioner2  -->
                <id value="421269ad-abef-49bc-8cac-d3a5d4b00299" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/PractitionerPerson" />
                </meta>
                <identifier>
                    <system value="urn:oid:2.16.840.1.113883.4.6" />
                    <value value="1972548287" />
                </identifier>
                <name>
                    <family value="Liyanage" />
                    <given value="Udaya" />
                    <prefix value="Dr." />
                </name>
                <telecom>
                    <system value="phone" />
                    <value value="(618) 942-2002" />
                    <use value="work" />
                </telecom>
                <address>
                    <line value="220 S PARK AVE" />
                    <city value="HERRIN" />
                    <state value="IL" />
                    <postalCode value="62948" />
                </address>
            </Practitioner>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:25fa3dbc-dc9e-42c2-b681-0352765645af" />
        <resource>
            <Location>
                <!--  ServiceDeliveryLocationInitiator  -->
                <id value="25fa3dbc-dc9e-42c2-b681-0352765645af" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/ServiceDeliveryLocation" />
                </meta>
                <identifier>
                    <system value="urn:oid:2.16.840.1.113883.4.6" />
                    <value value="1659603009" />
                </identifier>
                <name value="Alliance Of Chicago Therapeutic Services and Supplies" />
                <type>
                    <coding>
                        <system value="http://hl7.org/CodeSystem/organization-type" />
                        <code value="prov" />
                        <display value="Healthcare Provider" />
                    </coding>
                </type>
                <telecom>
                    <system value="phone" />
                    <value value="(909) 427-5000" />
                    <use value="work" />
                </telecom>
                <address>
                    <use value="work" />
                    <line value="2800 W PETERSON AVE" />
                    <city value="Chicago" />
                    <state value="IL" />
                    <postalCode value="60659" />
                    <country value="USA" />
                </address>
            </Location>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:17d9e3c9-a6a8-4550-b4db-d6f5a453d983" />
        <resource>
            <Location>
                <!--  ServiceDeliveryLocationRecipient -->
                <id value="17d9e3c9-a6a8-4550-b4db-d6f5a453d983" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/ServiceDeliveryLocation" />
                </meta>
                <identifier>
                    <system value="urn:oid:2.16.840.1.113883.4.6" />
                    <value value="1215372123" />
                </identifier>
                <name value="YMCA of Metropolitan Chicago" />
                <type>
                    <coding>
                        <system value="http://hl7.org/CodeSystem/organization-type" />
                        <code value="prov" />
                        <display value="Healthcare Provider" />
                    </coding>
                </type>
                <telecom>
                    <system value="phone" />
                    <value value="(909) 427-5000" />
                    <use value="work" />
                </telecom>
                <address>
                    <use value="work" />
                    <line value="1030 W Van Buren St" />
                    <city value="Chicago" />
                    <state value="IL" />
                    <postalCode value="60607" />
                    <country value="USA" />
                </address>
            </Location>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:598af951-66e4-4910-a964-7e41533b183c" />
        <resource>
            <Practitioner>
                <!--  Practitioner1  -->
                <id value="598af951-66e4-4910-a964-7e41533b183c" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/PractitionerPerson" />
                </meta>
                <identifier>
                    <system value="urn:oid:2.16.840.1.113883.4.6" />
                    <value value="1063784882" />
                </identifier>
                <name>
                    <family value="Heard" />
                    <given value="Elisa" />
                    <prefix value="Dr." />
                </name>
                <telecom>
                    <system value="phone" />
                    <value value="(847) 548-6000" />
                    <use value="work" />
                </telecom>
                <address>
                    <line value="18640 West Belvidere Road" />
                    <city value="Grayslake" />
                    <state value="IL" />
                    <postalCode value="60030" />
                </address>
            </Practitioner>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
        <resource>
            <Patient>
                <id value="cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/PatientRole" />
                </meta>
                <identifier>
                    <type>
                        <coding>
                            <system value="http://hl7.org/fhir/v2/0203" />
                            <code value="MR" />
                            <display value="Medical Record Number" />
                        </coding>
                    </type>
                    <system value="urn:oid:2.16.840.1.113883.4.3.17" />
                    <value value="F255-9215-0094" />
                </identifier>
                <name>
                    <use value="official" />
                    <family value="Beal" />
                    <given value="Bradley" />
                </name>
                <telecom>
                    <system value="phone" />
                    <value value="(999) 607-2500" />
                </telecom>
                <gender value="male" />
                <birthDate value="1950-03-22" />
                <address>
                    <line value="609 Lizeth Streets" />
                    <city value="Chicago" />
                    <state value="IL" />
                    <postalCode value="60609" />
                </address>
                <communication>
                    <language>
                        <coding>
                            <system value="urn:ietf:bcp:47" />
                            <code value="en-US" />
                            <display value="English (United States)" />
                        </coding>
                    </language>
                    <preferred value="true" />
                </communication>
            </Patient>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:29be9d88-0027-4f02-9b2c-f7a27aaaf10b" />
        <resource>
            <Observation>
                <id value="29be9d88-0027-4f02-9b2c-f7a27aaaf10b" />
                <status value="final" />
                <code>
                    <coding>
                        <system value="http://loinc.org" />
                        <code value="80913-7" />
                        <display value="Highest level of education" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                </subject>
                <valueCodeableConcept>
                    <coding>
                        <system value="http://hl7.org/fhir/v3/EducationLevel/vs.html" />
                        <code value="BD" />
                        <display value="College or baccalaureate degree complete" />
                    </coding>
                </valueCodeableConcept>
            </Observation>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:22449d51-3d71-49bd-a79a-c1f7557e09ef" />
        <resource>
            <Observation>
                <id value="22449d51-3d71-49bd-a79a-c1f7557e09ef" />
                <status value="final" />
                <code>
                    <coding>
                        <system value="http://loinc.org" />
                        <code value="74165-2" />
                        <display value="History of employment status" />
                    </coding>
                </code>
                <subject>
                    <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                </subject>
                <valueCodeableConcept>
                    <coding>
                        <system value="http://hl7.org/fhir/v2-0066" />
                        <code value="1" />
                        <display value="Full time employed" />
                    </coding>
                </valueCodeableConcept>
            </Observation>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:e6d1abc8-595f-41ab-a6dc-13a034d3fac7" />
        <resource>
            <Organization>
                <id value="e6d1abc8-595f-41ab-a6dc-13a034d3fac7" />
                <identifier>
                    <system value="urn:oid:2.16.840.1.113883.4.6" />
                    <value value="1659603009" />
                </identifier>
                <type>
                    <coding>
                        <system value="http://hl7.org/CodeSystem/organization-type" />
                        <code value="prov" />
                        <display value="Healthcare Provider" />
                    </coding>
                </type>
                <name value="Alliance Of Chicago Therapeutic Services and Supplies" />
                <telecom>
                    <system value="phone" />
                    <value value="(773)-661-4499" />
                </telecom>
                <address>
                    <use value="work" />
                    <line value="2800 W PETERSON AVE" />
                    <city value="Chicago" />
                    <state value="IL" />
                    <postalCode value="60659" />
                    <country value="USA" />
                </address>
            </Organization>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:f5db0002-3a69-472b-9263-be8d977fdaff" />
        <resource>
            <Organization>
                <!--  OrganizationEntity2  -->
                <id value="f5db0002-3a69-472b-9263-be8d977fdaff" />
                <identifier>
                    <system value="urn:oid:2.16.840.1.113883.4.6" />
                    <value value="1215372123" />
                </identifier>
                <type>
                    <coding>
                        <system value="http://hl7.org/CodeSystem/organization-type" />
                        <code value="prov" />
                        <display value="Healthcare Provider" />
                    </coding>
                </type>
                <name value="YMCA of Metropolitan Chicago" />
                <telecom>
                    <system value="phone" />
                    <value value="(909) 427-5000" />
                    <use value="work" />
                </telecom>
                <address>
                    <use value="work" />
                    <line value="1030 W Van Buren St" />
                    <city value="Chicago" />
                    <state value="IL" />
                    <postalCode value="60607" />
                    <country value="USA" />
                </address>
            </Organization>
        </resource>
    </entry>
    <entry>
        <fullUrl value="urn:uuid:0bdbb1e5-5016-4291-8249-d16d8d07181f" />
        <resource>
            <Bundle>
                <!--  DiabetesRequestSupportBundle  -->
                <id value="0bdbb1e5-5016-4291-8249-d16d8d07181f" />
                <meta>
                    <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/DiabetesRequestSupportBundle" />
                </meta>
                <type value="collection" />
                <entry>
                    <fullUrl value="urn:uuid:f08e2abf-30c5-49b0-9ada-105d52204ca6" />
                    <resource>
                        <Observation>
                            <!--  BodyMassIndexObservation1  -->
                            <id value="f08e2abf-30c5-49b0-9ada-105d52204ca6" />
                            <meta>
                                <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/BodyMassIndexObservation" />
                            </meta>
                            <status value="final" />
                            <category>
                                <coding>
                                    <system value="http://hl7.org/fhir/observation-category" />
                                    <code value="vital-signs" />
                                    <display value="Vital Signs" />
                                </coding>
                            </category>
                            <code>
                                <coding>
                                    <system value="http://loinc.org" />
                                    <code value="39156-5" />
                                    <display value="Body mass index (BMI) [Ratio]" />
                                </coding>
                            </code>
                            <subject>
                                <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                            </subject>
                            <effectiveDateTime value="2018-12-11" />
                            <valueQuantity>
                                <value value="31.2" />
                                <unit value="kg/m2" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="kg/m2" />
                            </valueQuantity>
                        </Observation>
                    </resource>
                </entry>
                <entry>
                    <fullUrl value="urn:uuid:6f99e55a-66a7-453f-b78f-e6821dc5e556" />
                    <resource>
                        <Observation>
                            <!--  BodyWeightObservation1  -->
                            <id value="6f99e55a-66a7-453f-b78f-e6821dc5e556" />
                            <meta>
                                <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/BodyWeightObservation" />
                            </meta>
                            <status value="final" />
                            <category>
                                <coding>
                                    <system value="http://hl7.org/fhir/observation-category" />
                                    <code value="vital-signs" />
                                    <display value="Vital Signs" />
                                </coding>
                            </category>
                            <code>
                                <coding>
                                    <system value="http://loinc.org" />
                                    <code value="29463-7" />
                                    <display value="Body Weight" />
                                </coding>
                            </code>
                            <subject>
                                <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                            </subject>
                            <effectiveDateTime value="2018-12-11" />
                            <valueQuantity>
                                <value value="105" />
                                <unit value="kg" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="kg" />
                            </valueQuantity>
                        </Observation>
                    </resource>
                </entry>
                <entry>
                    <fullUrl value="urn:uuid:cc841086-4f22-4b92-8ab4-4446fc506ebf" />
                    <resource>
                        <Observation>
                            <!--  HemoglobinA1cObservation1  -->
                            <id value="cc841086-4f22-4b92-8ab4-4446fc506ebf" />
                            <meta>
                                <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/A1cObservation" />
                            </meta>
                            <status value="final" />
                            <category>
                                <coding>
                                    <system value="http://hl7.org/fhir/observation-category" />
                                    <code value="vital-signs" />
                                    <display value="Vital Signs" />
                                </coding>
                            </category>
                            <code>
                                <coding>
                                    <system value="http://loinc.org" />
                                    <code value="4548-4" />
                                    <display value="Hemoglobin A1c/​Hemoglobin.total in Blood" />
                                </coding>
                            </code>
                            <subject>
                                <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                            </subject>
                            <effectiveDateTime value="2018-12-11" />
                            <valueQuantity>
                                <value value="128" />
                                <unit value="mg/dL" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="mg/dL" />
                            </valueQuantity>
                        </Observation>
                    </resource>
                </entry>
                <entry>
                    <fullUrl value="urn:uuid:f4faa626-d79e-4b5b-b898-57f25c9dca0b" />
                    <resource>
                        <Observation>
                            <!--   BodyHeightObservation1  -->
                            <id value="f4faa626-d79e-4b5b-b898-57f25c9dca0b" />
                            <meta>
                                <profile value="http://hl7.org/fhir/us/bser/StructureDefinition/BodyHeightObservation" />
                            </meta>
                            <status value="final" />
                            <category>
                                <coding>
                                    <system value="http://hl7.org/fhir/observation-category" />
                                    <code value="vital-signs" />
                                    <display value="Vital Signs" />
                                </coding>
                            </category>
                            <code>
                                <coding>
                                    <system value="http://loinc.org" />
                                    <code value="8302-2" />
                                    <display value="Body height" />
                                </coding>
                            </code>
                            <subject>
                                <reference value="urn:uuid:cec258d7-a76a-4a1d-bc4c-c656b0a5d6f8" />
                            </subject>
                            <effectiveDateTime value="2018-12-11" />
                            <valueQuantity>
                                <value value="182.88" />
                                <unit value="cm" />
                                <system value="http://unitsofmeasure.org" />
                                <code value="cm" />
                            </valueQuantity>
                        </Observation>
                    </resource>
                </entry>
            </Bundle>
        </resource>
    </entry>
</Bundle>