Referral Generator

When to Use This Skill

Use when a clinician needs to create a specialist referral with supporting clinical documentation compiled from the patient's FHIR record.

Clinical Workflow

1. Use fhir_read to retrieve Patient demographics and insurance (Coverage) for referral header
2. Use fhir_search to pull relevant Condition resources for the referral indication
3. Use fhir_search to pull relevant Observation resources (labs, vitals) supporting the referral
4. Use fhir_search to pull active MedicationRequest resources for current treatment context
5. Use fhir_search to pull relevant Procedure resources for prior interventions
6. Compile referral package: demographics, insurance, referring diagnosis, clinical question, relevant labs/vitals, current medications, prior treatments attempted
7. Use fhir_create to create ServiceRequest resource with category=referral, reasonCode, and supportingInfo references

FHIR Resources

• Patient -- Demographics for referral header
• Coverage -- Insurance for authorization
• Condition -- Referral indication and supporting diagnoses
• Observation -- Relevant lab results and vitals
• MedicationRequest -- Current medications
• Procedure -- Prior related procedures
• ServiceRequest -- Output: referral order

FHIR Query Examples

Create Referral Order

fhir_create(resourceType="ServiceRequest", resource={"resourceType":"ServiceRequest","status":"active","intent":"order","category":[{"coding":[{"system":"http://snomed.info/sct","code":"3457005","display":"Patient referral"}]}],"code":{"text":"[specialty] referral"},"subject":{"reference":"Patient/[patient-id]"},"reasonCode":[{"text":"[referral reason]"}]})

Clinical Guidelines

• CMS referral and prior authorization requirements
• Specialty-specific referral criteria (e.g., nephrology at eGFR <30, cardiology for new murmur/arrhythmia)

Interpretation Guide

• Structure the referral with: reason for referral (clinical question), relevant history, current medications, pertinent labs, prior treatments, specific request (evaluation, co-management, procedure)
• Include insurance authorization requirements if applicable
• Flag urgent referrals: conditions requiring expedited evaluation (suspected malignancy, acute decompensation, new neurologic deficit)

Safety

• Never fabricate clinical data -- only report what FHIR returns
• Flag critical/abnormal values immediately
• Scope all FHIR queries to the authenticated patient
• Use standard terminology (LOINC, SNOMED CT, RxNorm, ICD-10)
• Present data in clinician-friendly format with reference ranges