Referrals

General information

The Referrals module contains all e-referrals issued for a patient as recorded by medical specialists in the National Health Information System (NHIS). Referrals are divided into three groups: pending, completed, and invalid.
There are five different types of e-referrals in NHIS for: laboratory tests (NHIF 4), consultation (NHIF 3), highly specialized activities (3A), hospitalization (NHIF 7), and medical expertise (NHIF 6).
Each e-referral’s type and National Reference Number (NRN) are visible in the module. Pending referrals show a referral’s expiration date and a special color scale indicates how much time is left till expiry. Completed referrals display date of completion of a referral. Invalid referrals are those that have been canceled, rejected, or expired.

Download eZdrave to access your referrals or visit my.his.bg

Key functionalities

Each e-referral has a unique barcode containing a document's National Reference Number (NRN). By scanning the code, the referral can be completed without the patient needing to provide additional information (such as personal identification number, date of issue, etc.).

Special icons allow direct access to all documents attached to an e-referral. For issued e-referrals, this includes access to the e-examination which generated the referral, and for completed referrals – the results/subsequent examinations.

If the medical specialist who has issued the referral has provided an email or phone number, they can be contacted directly via the icon next to their name.

Each referral contains information about the reason for it, primary diagnosis and comorbidity (if any).

Each completed e-referral includes data about the funding source; the name and unique identification number (UIN) of the medical specialist who issued it; the NRN of the examination when it was issued; and its issue date.

Key functionalities

Each e-referral has a unique barcode containing a document's National Reference Number (NRN). By scanning the code, the referral can be completed without the patient needing to provide additional information (such as personal identification number, date of issue, etc.).

Special icons allow direct access to all documents attached to an e-referral. For issued e-referrals, this includes access to the e-examination which generated the referral, and for completed referrals – the results/subsequent examinations.

If the medical specialist who has issued the referral has provided an email or phone number, they can be contacted directly via the icon next to their name.

Each referral contains information about the reason for it, primary diagnosis and comorbidity (if any).

Each completed e-referral includes data about the funding source; the name and unique identification number (UIN) of the medical specialist who issued it; the NRN of the examination when it was issued; and its issue date.

Steps for issuing, downloading, and executing an e-referral

Arrow timeline

  1. 1 A referring physician issues an e-referral (for tests, consultation, highly specialized activities, hospitalization, or medical expertise) by submitting a request to NHIS. If a patient has installed the eZdrave app and has enabled notifications, they will receive a notification on their mobile device about an issued e-referral.

  2. 2 Patient visits a laboratory/specialist(s), and an e-referral is downloaded with a request to NHIS. E-referral’s status changes to downloaded, but it can still be downloaded by another laboratory or doctor.

    When requesting to download an e-referral for laboratory tests, NHIS only shows referrals for lab tests with a status of active, canceled, downloaded, processing, or partially fulfilled.

  3. 3 If an e-referral is for laboratory tests, a laboratory sends a request to NHIS, specifying the activities being processed. E-referral’s status changes to processing and it can no longer be downloaded by another laboratory. If an e-referral is for hospitalization and the attending doctor, after an examination, determines the necessity for admission to a medical facility, they send a request to NHIS indicating the type of admission (planned or emergency).

    Referral’s status changes to processing but it can still be retrieved and used by another doctor in another hospital. If corrections or updates to the submitted data are needed, the laboratory performing the e-referral’s medical diagnostic activities can submit a request to NHIS to make the necessary changes.

  4. 4 After completing a physical examination, an attending doctor creates an e-examination document with a request to NHIS, mandatorily submitting the NRN of the e-referral. This changes the status of the e-referral to completed. For laboratory test referrals, completed status is received after the laboratory submits the results of the executed medical diagnostic activities and sends a request to NHIS.

    For hospitalization, the hospital system sends a request to NHIS to create an e-hospitalization document, mandatorily submitting the NRN of said e-referral. This changes e-referral’s status to completed. A referral for medical expertise receives a completed status once all examinations have been concluded. Referrals for laboratory tests and medical expertise can receive a partially completed status. This status is used when results for all activities/ examinations included in said referral have not yet been submitted.

  5. 5 The referring physician can review the results of completed e-referrals.

  1. 1 A referring physician issues an e-referral (for tests, consultation, highly specialized activities, hospitalization, or medical expertise) by submitting a request to NHIS. If a patient has installed the eZdrave app and has enabled notifications, they will receive a notification on their mobile device about an issued e-referral.

  2. 2 Patient visits a laboratory/specialist(s), and an e-referral is downloaded with a request to NHIS. E-referral’s status changes to downloaded, but it can still be downloaded by another laboratory or doctor.

    When requesting to download an e-referral for laboratory tests, NHIS only shows referrals for lab tests with a status of active, canceled, downloaded, processing, or partially fulfilled.

  3. 3 If an e-referral is for laboratory tests, a laboratory sends a request to NHIS, specifying the activities being processed. E-referral’s status changes to processing and it can no longer be downloaded by another laboratory. If an e-referral is for hospitalization and the attending doctor, after an examination, determines the necessity for admission to a medical facility, they send a request to NHIS indicating the type of admission (planned or emergency).

    Referral’s status changes to processing but it can still be retrieved and used by another doctor in another hospital. If corrections or updates to the submitted data are needed, the laboratory performing the e-referral’s medical diagnostic activities can submit a request to NHIS to make the necessary changes.

  4. 4 After completing a physical examination, an attending doctor creates an e-examination document with a request to NHIS, mandatorily submitting the NRN of the e-referral. This changes the status of the e-referral to completed. For laboratory test referrals, completed status is received after the laboratory submits the results of the executed medical diagnostic activities and sends a request to NHIS.

    For hospitalization, the hospital system sends a request to NHIS to create an e-hospitalization document, mandatorily submitting the NRN of said e-referral. This changes e-referral’s status to completed. A referral for medical expertise receives a completed status once all examinations have been concluded. Referrals for laboratory tests and medical expertise can receive a partially completed status. This status is used when results for all activities/ examinations included in said referral have not yet been submitted.

  5. 5 The referring physician can review the results of completed e-referrals.

In NHIS, the issuance of a referral can be backdated by up to 3 days, and a referral’s execution – by up to 7 days.