Identity, routing, privacy, and audit are referral safety controls
Referral governance is not separate from clinical operations. If the platform cannot match the patient correctly, route to the right provider, and prove who saw what, every downstream status becomes suspect.
Governance controls that materially affect referral operations
| Control area | What it governs | Failure mode |
|---|---|---|
| Patient identity | Correct matching, merging, and longitudinal linking of referrals and results. | Wrong-patient routing, duplicate work, or hidden prior history. |
| Provider and organization identity | Destination routing, provenance, and who is accountable for each state change. | Results return to the wrong endpoint or lack legal traceability. |
| Privacy and audit | Who may access referral data and how disclosure is traced. | Unauthorized access, weak incident investigation, or poor patient trust. |
Identity-aware referral routing
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Health identity developer guidance (NHI and HPI)
Health New Zealand developer guidance on national NHI and HPI services used by systems that need authoritative patient and provider identifiers.
Read the identity integration guidanceHealth Information Privacy Code 2020
New Zealand privacy code governing collection, use, storage, access, and disclosure of health information.
Read the privacy codeRegional operating models turn standards into real referral behavior
A regional program usually adds business rules on top of the message contract. Health New Zealand's CRR materials are useful because they show how current triage, identity, and hub operations combine into one operating model, while the older contained HISO 10011 documents still illustrate the business-state vocabulary underneath closed-loop referrals.
Current New Zealand examples used in referral architecture
| Artifact | What it contributes |
|---|---|
| Contained HISO 10011.1 and 10011.3 | Legacy referral business states and status events that are still useful for studying workflow design, even though they are not current approval guidance for new-system development. |
| HISO 10008.2 | National radiology and pathology messaging structure for HL7 v2 payloads. |
| CRR hub design and primary-care guidance | Regional triage, priority codes, and direct-access imaging operating rules. |
CRR priority examples described in current guidance
| Priority | Meaning |
|---|---|
| Acute | Immediate or near-immediate clinical need. |
| P1 / Urgent | Urgent work that should move ahead of routine queues. |
| P2 | Semi-urgent work with shorter expected lead time. |
| P3 | Routine or non-urgent work. |
| S | Surveillance or a specified future date. |
Contained standards are design references, not fresh approval signals
As of March 11, 2026, Health New Zealand lists the HISO 10011 suite as contained legacy material that is no longer updated and should not be used for development of new systems. It remains useful here as an explicit referral-state design reference.
Date-sensitive policy example
As of March 11, 2026, Health New Zealand's public CRR page describes a phased rollout with full implementation projected from July 2026. Regional access criteria, rollout sequencing, and co-payment rules are operational policy, so implementation teams should verify the live programme guidance before production rollout.
Community Referred Radiology programme overview
Health New Zealand programme page describing the CRR operating context, phased rollout, and current programme-level policy signals.
Read the CRR programme overviewCommunity Referred Radiology Hub Design
Design document describing the regional hub model and how CRR referrals are triaged and managed operationally.
Read the CRR hub designInteroperability standards approval status
Current Health New Zealand standards-status page noting which interoperability standards are active and which, including HISO 10011, are contained legacy material.
Review current standards statusRegional result-sharing changes the final hop of the referral loop
Some regional architectures do more than route reports directly back to one referrer endpoint. They also publish results into shared repositories or regional exchange services, which changes how provenance, disclosure, and access need to be governed.
That means the final result hop is not just a transport concern. Teams need to know which repository receives the report, which organizations can view it, how patient and provider identity are preserved, and how the sending event is audited.
Regional result-sharing flow
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TestSafe radiology result-sharing guidance
Health New Zealand guidance for radiology providers sending reports into the TestSafe regional repository context.
Read the TestSafe radiology guidanceHealth Information Privacy Code 2020
Privacy code that governs disclosure, access, and storage obligations when referral results are shared beyond one direct endpoint.
Review the disclosure rulesKnowledge Check
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