DFT - The specification is currently in development and subject to change. For a full list of available versions, see the Directory of published versions

Level 3 System Capabilities

Level 3 systems build upon status tracking capabilities of Level 2 systems by:

• exchanging information about appointments that are scheduled as a result of an eReferral
• providing a secure method of communication between Health Care Providers to clarify the intent of eReferal or eConsult, to request additional supporting information, to seek clarification of advice given through an eConsult, etc.
• enabling advanced workflows that support:
  • Single Entry Models,
  • splitting of requisitions into multiple requests,
  • association of downstream referrals to the initial request

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L3: Appointments

Important milestones within an eReferral workflow are the booking and completion of an appointment for the patient to receive the requested service.

A core feature of Level 3 systems is the ability for a Target System to provide Appointment information back to the Source System using messaging. The exchange pattern is similar to that used to track status.

A Target System claiming compliance with Level 3 SHALL have the ability to to generate and transmit valid messages to a Source System that focus on an Appointment when an Appointment is created, booked, rescheduled or cancelled.

A Source System claiming compliance with Level 3 SHALL have the ability to receive and appropriately process a valid messages received from a Target System when the state of a request changes.

Trigger Events & Interactions

Party	Action / Trigger	Sending System	Focus of Message	State Change	Event Code	Receiving System	Expected action upon receipt of message
Performer HCP	Books an appointment in response to a referral request	Target System	Appointment (CA:eReC)	Appointment added to service record	notify-add-appointment (L3)	Source RMS	Store the appointment received within the service record for access by the user (etc)
Performer HCP	Updates an appointment	Target System	Appointment (CA:eReC)	Appointment updated in service record	notify-update-process-request (L3)	Source RMS	Update appointment information within the service record
Performer HCP	Cancels an appointment	Target System	Appointment (CA:eReC)	Appointment removed in service ecord	notify-update-process-request (L3)	Source RMS	Remove the appointment from the service record

Note: In Advanced Workflows (L3), Central Systems MAY use the Informer/Recipient integration to transmit inforamtion back to the Source System.

Appointment Modifications

Transmission of a change or cancellation to a scheduled appointment is supported by the “notify-update-process-request” event.

Allowed changes include:

• a change to an appointment date
• change in location
• change in specialist
• change in status

Virtual Visits

This specification has pre-adopted the Appointment.class and Appointment.virtualService elements on Appointment (CA:eReC) to allow implementers to communicate that a referral will be fulfilled by a virtual encounter with location.

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