A006 - Referral letter identifier

e-Referral Service (e-RS) e-Referral Service FHIR API
1

Is there any way to identify which attachment is the referral letter?

It has been suggested that we could use the document description field, but that would rely on trying to do some matching on a free text field which isn’t mandatory, which would seem unreliable.

2

Hi @phil.walker3 -

There isn’t a systemic way unfortunately.

Unable to identify the ‘referral letter’ from a bunch of attachments is a consequence of:

  • Referrers attaching files without meaningful names
  • The integrated GP system renaming files to generic descriptions

The suggestion is valid but would require a big process shift in the referrer space. Understand your concerns however.

Thanks,
Z.

3

Hi @phil.walker3,

Just to clarify further. When the e-RS refers to the “referral letter” it is generally referring to the set (1 or more) of files uploaded by the referrer that constitutes the referrer clinical information.

You can identify this set of files from the A005 response by using the DocumentReference.type. e.g.:

"type": {
    "coding": [
    {
        "system": "https://fhir.nhs.uk/STU3/CodeSystem/eRS-AttachmentType-1",
        "code": "REFERRER",
        "display": "Referrer"
    }]
}

However, often within this set of files one of the files is a letter that includes a narrative around the referral, which is also referred to as a “referral letter”. Other files may then just be supporting information.

If you are referring to this second use of the term then as Zubeir has said there is nothing currently that lets you determine which file within the referrer clinical information set this is.

Regards,

Adam.