Referral Management

Monitor your patients for referrals & specialist visits

πŸ“– Background

Particle offers Referral Management as part of our Monitoring Solution. This product enables our customers to enroll a patient (or a cohort of patients) that they have referred to another provider outside of their own provider group or network. Once the customer shares the information about the referral, Particle Health will then start monitoring the health information networks to see when new data has come in from that facility for that patient. Your team will receive a notification that data is ready to be pulled down and you will be passed any net new data that was generated by that encounter. You will also be able to know when a patient did not follow up on a referral so you can take action.

This ultimately can result in providing better care, and is especially important in value-based care arrangements.

πŸ› οΈ Configuring Referral Management

To set up Referral Management for a single patient or a cohort of patients, you can follow the configuration steps outlined in Patient Monitoring. Per that process, once you have generated authentication and created your patients, you can leverage the Subscriptions API to enroll a single patient or cohort of patients to monitor for referrals (i.e., to Referral Alerts).

There is one additional step you will need to take BEFORE setting up your subscriptions with the Subscriptions API, which is to register the Referral Organizations that you want Particle to monitor for referrals for your patients.

πŸ₯ Register Referral Organizations

The Referral Organizations API enables you to register the list of organizations to which you typically refer your patients. You will need to register ReferralOrganizations that you want to Particle to monitor for patient referrals before you subscribe your patients to Referral Alerts.

Particle will provide the list of all organizations - including the organization / facility name, address, and the OID for each facility - to which you can subscribe to Referral Alert notifications. Please reach out to your Particle Health representative and we're happy to share this list!

You can register any Referral Organizations on this list by passing the organization oid (i.e., unique identifier) in a request to the Referral Organizations API. See example below:

Example Request - Register Referral Organizations

Description:Register organizations you want to monitor for referrals
Path:api.particlehealth.com/api/v1/referrals/organizations
Method:POST

curl --request POST \
     --url https://api.particlehealth.com/api/v1/referrals/organizations \
     --header 'accept: application/json' \
     --header 'content-type: application/json'
{  
    "organizations": [  
        {  
            "oid": "2.16.840.1.113883.3.8391.5.710576"  
        }  
    ]  
}

In addition to registering your ReferralOrganizations, this API allows you to retrieve a list of all Referral Organizations that you are tracking for Referral Alerts cross your entire patient population, as well as delete any Referral Organizations. Check out the Referral Organizations API Reference for more details.

πŸ‘¨β€πŸ‘©β€πŸ‘§β€πŸ‘¦ Subscribe a Cohort of Patients to Referral Alerts

If you want to enroll a cohort of patients to monitor for referrals, you will need to leverage the Subscriptions API to subscribe to Referral Alert notifications for the patients.

As described in Subscriptions Implementation, you can make a single POST request with all patients that you want to subscribe to all types of monitoring notifications (including Referral Alerts, ADTs, etc), or you can opt to place separate calls for certain cohorts of patients or certain types of notifications. The API is intended to be flexible to support whichever workflows and model makes sense for your organization. See Subscriptions Implementation for more information.

Specify Referral Organizations - "Referred to OID"

In addition to providing the particle_patient_id and start_date and end_date for each request that you place to subscribe patient(s) Referral Alerts, you will also need to provide the referred_to_oid, which is the oid (i.e., unique identifier) for the organization or facility to which you referred the patient. This will indicate to Particle which organization or facility to monitor for new data for the patient.

🚧

You must register the organizations you want Particle to monitor for referrals via the ReferralOrganization API (see above), before subscribing patients to Referral Alerts.

Example Request - Subscribe a Cohort to Referral Alerts

Description:Subscribe a cohort of patients to monitor for referral alerts
Path:api.particlehealth.com/api/v1/patients/subscriptions
Method:POST
curl --request POST \
     --url https://api.particlehealth.com/api/v1/patients/subscriptions \
     --header 'accept: application/json' \
     --header 'content-type: application/json'

Example Request Body - Subscribe a Cohort to Referral Alerts

{
	"subscriptions": [
		{
			"patient_id": "bc346510-ffc5-4126-a334-f08433405c11",
			"type": "REFERRAL_ALERT",
			"referred_to_oid": "2.16.840.1.113883.3.8391.5.69335"
		},
		{
			"patient_id": "bc346510-ffc5-4126-a334-f08433405c11",
			"type": "REFERRAL_ALERT",
			"referred_to_oid": "2.16.840.1.113883.3.8391.5.721775"
		},
		{
			"patient_id": "57aee5a3-ea03-4fdb-8304-b2cb15799cbd",
			"type": "REFERRAL_ALERT",
			"referred_to_oid": "2.16.840.1.113883.3.8391.5.69335"
		}
	]
}

Example Response - Subscribe a Cohort to Referral Alerts

{
	"subscriptions":[
		{
      "id": "67aeafc6-cc89-4a00-8202-3da0d49c676e",
      "type": "REFERRAL_ALERT",
      "referred_to_oid": "2.16.840.1.113883.3.8391.5.69335",
      "particle_patient_id": "bc346510-ffc5-4126-a334-f08433405c11",
      "state": "SUBSCRIBED"
		},
		{
        "id": "cd2d57ca-d73a-47eb-a069-a700562f19a2",
        "type": "REFERRAL_ALERT",
        "referred_to_oid": "2.16.840.1.113883.3.8391.5.721775",
        "particle_patient_id": "4b7e786c-bfdf-4d11-bf68-99a347d4b934",
        "state": "SUBSCRIBED"
		},
   {
        "id": "cd2d57ca-d73a-47eb-a069-a700562f19a2",
        "type": "REFERRAL_ALERT",
        "referred_to_oid": "2.16.840.1.113883.3.8391.5.69335",
        "particle_patient_id": "57aee5a3-ea03-4fdb-8304-b2cb15799cbd",
        "state": "SUBSCRIBED"
		}
	]
}

πŸ‘©πŸ»β€πŸ¦± Subscribe an Individual Patient to Referral Alerts

If preferred, you have the option of subscribing individual patients. The same data (Particle Patient ID, start date, end date, type, and referred_to_OID) is required to create an individual subscription.

Description:Subscribe a single patient to monitor for referral alerts
Path:api.particlehealth.com/api/v1/patients/{particle_patient_id}/subscriptions
Method:POST

Example Request - Subscribe an Individual Patient to Referral Alerts

curl --request POST \
     --url api.particlehealth.com/api/v1/patients/{particle_patient_id}/subscriptions \
     --header 'accept: application/json' \
     --header 'content-type: application/json'

Request Body - Subscribe an Individual Patient to Referral Alerts

{
	"subscriptions": [
		{
			"type": "REFERRAL_ALERT",
			"referred_to_oid": "2.16.840.1.113883.3.8391.5.69335",
		},
		{
			"type": "REFERRAL_ALERT",
			"referred_to_oid": "2.16.840.1.113883.3.8391.5.721775",
		},
	]
}

Response Model - Subscribe an Individual Patient to Referral Alerts

{
 "subscriptions":[
		{
			"id": "67aeafc6-cc89-4a00-8202-3da0d49c676e",
			"particle_patient_id": "4b7e786c-bfdf-4d11-bf68-99a347d4b934",
			"type": "REFERRAL_ALERT",
			"referred_to_oid": "2.16.840.1.113883.3.8391.5.69335",
			"state": "SUBSCRIBED"
		},
		{
			"id": "90ed4f35-72fe-4083-a347-a30cf452f89f",
			"particle_patient_id": "4b7e786c-bfdf-4d11-bf68-99a347d4b934",
			"type": "REFERRAL_ALERT",
			"referred_to_oid": "2.16.840.1.113883.3.8391.5.721775",
			"state": "SUBSCRIBED"
		}
	]
}

Error Response (Validation Error) - Subscribe an Individual Patient to Referral Alerts

{
    "subscriptions": [
        {
            "type": "REFERRAL_ALERT",
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "2.16.840.1.113883.3.8391.5.69335",
            "error": "REFERRAL_ALERT subscription already exists"
        },
        {
            "type": "REFERRAL_ALERT",
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "2.16.840.1.113883.3.8391.5.69335",
            "error": "end_date: 2024-01-01 should be after start_date: 2024-12-31"
        },
        {
            "type": "REFERRAL_ALERT",
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "2.16.840.1.113883.3.8391.5.69335.1",
            "error": "referred to organization must be setup before setting up patient referrals"
        }
    ]
}

πŸ”” Referral Alert Notifications

Particle continuously monitors the networks for new encounters. When we identify a new patient encounter at an organization / facility we are monitoring for referrals for your patient, we will update the referral status to COMPLETE and send a Referral Alert Notification to the endpoint that you have set up to receive notifications.

Referral Alert Notification Payload

{
  "specversion":"1.0",
  "type":"com.particlehealth.api.v2.referralalert",
  "source": "api/notifications",
  "id": "f834539f-a839-490b-80f9-b441cb9e435d",
  "time":"2023-05-15T12:00:14.694292853Z",
  "datacontenttype":"application/json",
  "data":{
    "network_organization": {
      "name": "Rochester Hospital",
      "oid": "2.16.840.1.113883.3.8391.5.710576"
    },
    "particle_patient_id": "73630f6a-d8e3-4295-bf70-7214d68b4ed7",
    "referral_id": "df76019c-2fd9-42da-98a7-359b4dc66caf",
    "referral_status": "COMPLETE",
    "resources": [
      {
        "resource_ids": [
          "Encounter/e68f30e9-8342-4fb7-9bcb-6cab47d5c6b0"
        ]
      }
    ]
  }

🩺 Retrieving Referral Encounter Data

When you receive a Referral Alert Notification, you can opt to retrieve the full history for the patient, or just the net new data available for the patient, from our Deltas API in either FLAT or FHIR. Check out Retrieving Data Deltas for more details on the Deltas workflows for Referral Management.

πŸ‘€ Checking Referral Status

While Particle will notify you via a Referral Alert if there are any update(s) for the patients you have asked us to monitor referrals, you also have the option to proactively check on the status of any patient referrals that you have asked Particle to monitor, via the List Patient Referrals API.

You can GET the status of all referrals for a given patient, referral organization, or referral state, by passing the particle_patient_ids, referred_to_oid, or referral_states respectively.

The response will return the particle_patient_ids, referred_to_oid, and referral_states, and the timestamp at which the referral_state was last updated. If you do not pass any parameters, the response will include this information for all patient referrals that you have configured.

Description:Retrieve the status of any referral(s) that you are monitoring
Path:api.particlehealth.com/api/v1/referrals
Method:GET

Example Request - Retrieve all Referrals

curl --request POST \
     --url api.particlehealth.com/api/v1/referrals \
     --header 'accept: application/json' \
     --header 'content-type: application/json'

Example Response

{
    "referrals": [
        {
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "test-referral-oid-1",
            "state": "INCOMPLETE",
            "updated": "2024-06-18T18:49:02Z"
        },
        {
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "test-referral-oid-2",
            "state": "INCOMPLETE",
            "updated": "2024-06-24T17:13:22Z"
        },
        {
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "test-referral-oid-4",
            "state": "INCOMPLETE",
            "updated": "2024-06-24T17:20:00Z"
        },
        {
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "test-referral-oid-5",
            "state": "INCOMPLETE",
            "updated": "2024-06-24T19:51:51Z"
        },
        {
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "test-referral-oid-6",
            "state": "INCOMPLETE",
            "updated": "2024-06-24T19:52:23Z"
        },
        {
            "particle_patient_id": "d939196d-0c80-4e82-b0e1-19f9ee271085",
            "referred_to_oid": "test-referral-oid-7",
            "state": "INCOMPLETE",
            "updated": "2024-06-24T19:53:37Z"
        }
    ]
}