How can I send a referral using Direct Messaging?

Practice Fusion allows you to communicate with providers outside of your practice quickly and securely. Sending a referral using Direct Messaging allows for the exchange of patient health information across different EHR networks. Send referrals instantly to any provider, including multiple types of attachments:

  • Encounter notes: Signed or unsigned encounters of any note type (SOAP or simple)
  • Lab results: Results may be signed or unsigned and may contain structured and/or unstructured data
  • Imaging results: Results may be signed or unsigned and must contain structured data, i.e. reports only, not images
  • Documents: Signed or unsigned with any assigned document type
  • Referral Note document: Clinical documents formatted to the Consolidated Clinical Data Architecture (CCDA) Referral Note document template may be generated and attached directly within the referral workflow. These documents cannot be sent to recipients via fax, as the document is in a digital XML format; they must be sent electronically. If you are sending a referral by fax, Referral Note documents will need to be printed and faxed separately. For details on what data is included in a Referral Note document, please refer to Table 1 at the bottom of the page.
  • Continuity of Care Documents (CCDs): Clinical documents formatted to CCDA standards may be generated from the patient chart by following the guidelines here. A CCD cannot be sent to recipients via fax, as the document is in a digital XML format. If you are sending a referral by fax, CCDs will need to be printed and faxed separately. For details on what data is included in a CCD, please click here and refer to FAQ #2.

Follow the steps below to send a referral using Direct messaging in Practice Fusion:

1. Be provisioned a Direct address through Practice Fusion. For complete details on how to obtain a Direct account, please review the instructions here.

2. Reach out to your referral recipient Because the referral recipient will be using another certified EHR system, you must contact them directly to obtain their Direct address. You may then add your recipient as a new connection in your Directory and add their Direct address within their contact information.

3. Prepare any documents that will be sent with the referral Referrals cannot be saved as drafts, so if you plan to include specific documents in the referral, it’s helpful to prepare those documents in advance. Ensure that any necessary documents and lab results have been associated with the patient and that any encounter notes you plan to attach have been reviewed. Signed or unsigned encounters may be attached to referrals, and you can also generate any necessary Continuity of Care Documents (CCDs). For additional information, please see: How do I add attachments to referral letters?

4. Add a new referral
Within the patient's chart, click the Actions dropdown in the upper right corner and select Add referral.

Alternatively, open the patient encounter and scroll to the Referral section, then click Add.

Add_referral_from_encounterpng5. Select your recipient(s)
Click into the Recipient field and the My Connections pane will open to the left displaying your contacts. Select your Direct contact from your list of connections. If your Direct Message recipient is not currently in your My Connections list, click the (+) icon to add them as contact. As long as you’ve successfully been provisioned a Direct account, you’ll see a Direct address field. Add your colleague’s address to the Direct address field. (Note: If you do not have a Direct address, this field will not exist. In that case, you’ll need to request a Direct account). Once you have added your new contact, you will be able to select that contact from the My Connections list.

6. Select a specialty Select the referral recipient’s specialty. You may also use the optional On Behalf Of field to indicate if you are sending the referral on behalf of a provider in your practice.

7. Complete the referral message Click into the Referral For field to compose your referral. You may free-type your referral message or use a template. Referral templates will appear on the left -- you can use one of Practice Fusion’s general templates or Add a folder to create a brand new template, then add template line items as desired. For more information, please see: How do I create referral templates?

Referral_templatepng8. Add attachments Select any attachments you would like to send. Click your mouse into the Attachments field to see the attachable documents on the left. A complete list of attachable documents may be found at the top of this page.

  • Clinical documents formatted to the Consolidated Clinical Data Architecture (CCDA) standard are XML files that contain structured and unstructured patient data and can be formatted according to various document templates, such as the Referral Note document template. If you are choosing to generate a CCDA document formatted using the Referral Note document template, select the Generate referral note option at the bottom of the attachments pane.

For more detailed instructions on adding attachments to your referrals, please click here.

9. Review and send
Once you’ve confirmed your referral is complete, you can click Preview to review the full referral. When you’re ready, click Send to send the referral.

FAQs

How do I retrieve a Direct message from another provider? Direct messages can be retrieved within your Messages inbox.

How do I review referral letters? You can review all referrals sent for a patient in their Timeline by filtering to show Referrals. In the Timeline, you can review the time and date the referral was sent to each recipient, how the recipient received the referral, and confirm the referral status.

Referral_status_timelinepng

Table 1. Data included in each section of a Referral Note document

Referral Note document section name

Data elements included in section

Patient details & demographics

  • Patient name
  • Sex
  • Date of birth
  • Race
  • Ethnicity
  • Preferred language

Provider name & contact information

  • Referring provider’s name
  • Referring provider’s office contact information

Social history

  • Current smoking status
  • Birth sex

Problem list

  • Diagnoses with a start date assigned and no end date
  • Diagnoses associated with the selected signed encounter (if any)

Medications

  • Medications with a start date assigned
  • Medications associated with the selected signed encounter (if any)

Allergies

  • Drug allergies (food and environmental allergies not included)

Immunizations

  • Administered and historical immunizations

Results (Labs)

  • Signed lab results that have been entered in the patient chart

Vital signs

  • Vital signs associated with the selected signed encounter

Assessment & Plan

  • Plan for the selected signed encounter, if data is recorded
  • Care plan for the selected signed encounter, if data is recorded
  • Medication(s) attached to the selected signed encounter
  • Addendum(s) for the selected signed encounter, if data is recorded
  • Future lab & imaging orders attached to the selected signed encounter
  • Future appointments scheduled for after the date of Referral Note document generation

Referrals

  • All ordered referrals, including recipient name, contact information and reason for referral

Procedures

  • Coded procedures, assessments and screenings entered in the Screenings/Interventions/Assessments section of the selected signed encounter

Care team

  • Care team members as entered in the Profile section of the patient chart (name only)

Encounters

  • Selected signed encounter, including date of service, facility location, and any encounter diagnoses

Medical equipment

  • All Unique Device Identifiers (UDIs) for patient’s implantable devices (if any)

Functional status

  • Functional Status as entered in the Observations section of the selected signed encounter (if any)

Mental (Cognitive) status

  • Cognitive status as entered in the Observations section of the selected signed encounter (if any)

Goals

  • All active goals

Health concerns

  • All free-text health concerns
  • Health concerns associated with an allergy or diagnosis

Meaningful Use

  1. What is Meaningful Use?
  2. How do I attest for Meaningful Use?
  3. How does the Meaningful Use Dashboard work?
  4. 2018 Medicaid Meaningful Use Stage 2 Objective 1: Protect Patient Health Information
  5. 2018 Medicaid Meaningful Use Stage 2 Objective 2: Clinical Decision Support
  6. 2018 Medicaid Meaningful Use Stage 2 Objective 3: CPOE for Medication, Lab, and Radiology Orders
  7. 2018 Medicaid Meaningful Use Stage 2 Objective 4: Electronic Prescribing (eRx)
  8. 2018 Medicaid Meaningful Use Stage 2 Objective 5: Health Information Exchange
  9. 2018 Medicaid Meaningful Use Stage 2 Objective 6: Patient-Specific Education
  10. 2018 Medicaid Meaningful Use Stage 2 Objective 7: Medication Reconciliation
  11. 2018 Medicaid Meaningful Use Stage 2 Objective 8: Patient Electronic Access
  12. 2018 Medicaid Meaningful Use Stage 2 Objective 9: Secure Electronic Messaging
  13. 2018 Medicaid Meaningful Use Stage 2 Objective 10: Public Health Reporting
  14. 2017 Medicaid Meaningful Use Stage 2 Objective 1: Protect Patient Health Information
  15. 2017 Medicaid Meaningful Use Stage 2 Objective 2: Clinical Decision Support
  16. 2017 Medicaid Meaningful Use Stage 2 Objective 3: CPOE for Medication, Lab, and Radiology Orders
  17. 2017 Medicaid Meaningful Use Stage 2 Objective 4: Electronic Prescribing (eRx)
  18. 2017 Medicaid Meaningful Use Stage 2 Objective 5: Health Information Exchange
  19. 2017 Medicaid Meaningful Use Stage 2 Objective 6: Patient-Specific Education
  20. 2017 Medicaid Meaningful Use Stage 2 Objective 7: Medication Reconciliation
  21. 2017 Medicaid Meaningful Use Stage 2 Objective 8: Patient Electronic Access
  22. 2017 Medicaid Meaningful Use Stage 2 Objective 9: Secure Electronic Messaging
  23. 2017 Medicaid Meaningful Use Stage 2 Objective 10: Public Health Reporting
  24. 2017 Medicaid Meaningful Use Stage 2 Objective 10: Public Health - Immunization Registry Data Submission
  25. 2017 Medicaid Meaningful Use Stage 2 Objective 10: Public Health - Syndromic Surveillance Data Submission
  26. 2017 Medicaid Meaningful Use Stage 2 Objective 10: Public Health - Specialized Registry Reporting
  27. What are the Modified Stage 2 Meaningful Use requirements for 2017?
  28. What are the exclusions for Meaningful Use?
  29. What patients are counted for Meaningful Use?
  30. How do the components of a chart note relate to Meaningful Use?
  31. How do I print the Meaningful Use Dashboard?
  32. How do I minimize or refresh CDS notifications?
  33. How can I send a referral using Direct Messaging?
  34. How does patient portal access and auto-invite relate to Meaningful Use?
  35. What constitutes a "unique" patient?
  36. Meaningful Use attestation for previous years
  37. How do Meaningful Use payment adjustments work?
  38. How do I apply for a Meaningful Use Hardship Exception?
  39. How do I find Practice Fusion's CMS EHR Certification ID?
  40. How do I register for the Medicaid Meaningful Use Program?
  41. Can I change, modify, or cancel my attestation?
  42. How do I choose my reporting period duration for Medicaid Meaningful Use?
  43. Is Practice Fusion a certified EHR?
  44. Patient records maintained in the EHR for Meaningful Use attestation
  45. How do I get my AIU letter from Practice Fusion?
  46. How do I report eCQMs for Medicaid Meaningful Use?
  47. Do I have to meet all 10 objectives to achieve Meaningful Use?
  48. Can I participate in both MIPS (Medicare) and Meaningful Use (Medicaid)?
  49. Are there patient education materials available in Spanish?
  50. How do I select or change my reporting period start date?
  51. When do I need to sign chart notes for Meaningful Use? Can I sign a chart after the reporting period?
  52. How do I contact my state about the Medicaid EHR Incentive Program?
  53. How do I qualify for Meaningful Use if I see patients in multiple locations?
  54. How many exclusions can each provider claim for meaningful use?
  55. How do I use multiple EHR's to qualify for Medicaid Meaningful Use?
  56. What stage of Medicaid Meaningful Use am I in?
  57. How do I prepare for the PQRS Penalty Informal Review?
  58. How do I prepare for a Meaningful Use audit?
  59. How do I batch export patient data from the EHR?
  60. How can I report CQMs for PQRS?
  61. Diabetes: Low Density Lipoprotein (LDL) Management (CMS 163v4)
  62. Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control (CMS 182v5)
  63. Use of Appropriate Medications for Asthma (CMS 126v4)

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