Referrals: CMS urges updating NPPES endpoint info; ONC explains 360x workflow
Summary
CMS encouraged access organizations to populate digital endpoint fields in provider enrollment listings so referring clinicians can find referral endpoints; ONC reviewed the 360x referral workflow (CCDA + HL7 v2 over Direct) and cited vendor implementations.
Jacob Schiff urged access organizations to populate digital contact information (Firebase endpoints, secure messaging endpoints, etc.) in the provider enrollment system so CMS can surface endpoints in the access directory and referring clinicians can reliably send referrals. He compared failing to list endpoints to “having a business without a phone number.”
Brett Andresen from ONC walked through the 360x referral workflow, stressing that referral closing-the-loop is a workflow, not a single message: clinical content travels as CCDA documents, workflow/status messages use HL7 v2, and messages ride over Direct secure messaging. Brett noted 360x implementations exist across multiple vendors and observed that referrals can fail without well‑implemented endpoint discovery and tracking. He cited Epic, Netsmart, eClinicalWorks, Athenahealth and Node2 as current integrations.
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