Referral Order Linking

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The Referral/Order Linking profile describes what is necessary to communicate and link the referral and/or order number in documentation and metadata associated with services requested by an order placer.


One of the challenges for users of XD* based exchanges is that there is no profiled mechanism to indicate the order numbers associated with the outstanding orders. This makes it difficult to manage inbound and outbound referral, and /or order transactions for the same patient to and from the same providers exchanging information related to a referral or order.

The Referral/Order Linking profile solves this problem by documenting specific locations and formats, which will facilitate programmatic matching and or linking of related documents for both outbound and inbound transactions for the same patient to and or from the same provider. XD* provides metadata, and CDA provides discrete elements when structured documents are used; both can be constrained for defining order and referral number locations.

The referral, and or order number sent with one or more documents in an XD* submission set can be managed by receiving systems and returned in response fulfillments. This profile defines where these numbers are placed in XDS metadata for submissions and where fulfillments of orders are conveyed in CDA documents.



This profile facilitates programmatic matching and or linking of related documents for both outbound and inbound transactions for the same patient to and or from the same providers. It is intended to support care coordination in situations where outstanding requests for referrals, consultations, studies, lab tests or other services may need to be tracked or followed. These requests can be tracked using identifiers, often referred to as referral numbers or order numbers depending upon the type of service requested.


The Referral/Order Linking Profile describes the content and bindings used to convey order numbers between systems. The matching of content to order numbers happens in two directions. For example:

  1. submitted content in support of a healthcare referral needs to be matched and or linked by receiving systems
  2. content in response to a referral needs to be matched and or linked by receiving systems

Systems Affected

  • EHR systems may provide and consume order numbers to support the referral/order workflow

Actors & Transactions:



Profile Status: Trial Implementation


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Underlying Standards:

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See Also

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Related Profiles

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Consumer Information

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Implementer Information

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Reference Articles

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This page is based on the Profile Overview Template