Post-acute FHIR Order and Referrals

Post-acute FHIR Order and Referrals

The Centers for Medicare & Medicaid Services (CMS) has initiated the Post-Acute Fast Healthcare Interoperability Resources (FHIR) Orders project to support the CMS Promoting Interoperability initiatives. This project will define exchange methods, use of other interoperability standards and specific uses of Health Level Seven (HL7) FHIR to effectively exchange orders for Durable Medical Equipment (DME), Home Health Agency services, associated supplies, medications, and supporting clinical information (to qualify the order or establish medical necessity) between the ordering provider and the intended rendering provider or supplier.

Post-Acute FHIR Orders Implementation Guide

The Post-Acute FHIR Orders workflow is based on the HL7 Post-Acute Orders (PAO) Implementation Guide (IG) and the DME Order Substitutable Medical Applications, Reusable Technology (SMART) on FHIR application. The DME Order SMART on FHIR application is a prototype of the HL7 PAO Implementation Guide. The scope of the guide is to provide an electronic ordering of post-acute services, such as DME and Home Health services, with the electronic exchange of supporting documentation using RESTful and Messaging based exchanges between the ordering and performing providers.

To understand the detailed scope of the PAO Implementation Guide, please visit:

Post-Acute FHIR Orders Pilot Program and Workgroup

The EMDI Program supports and manages pilots that test the exchange of post-acute FHIR orders. The EMDI team manages and monitors the Post-Acute FHIR Orders pilots through workgroups.

The Post-Acute FHIR Orders Workgroup supports the pilots for the post-acute orders workflow, which is based on the PAO Implementation Guide and DME Order SMART on the FHIR application. This workgroup discusses pilot-related topics with the expectation of identifying how to successfully implement provider-to-provider interoperability using FHIR. This workgroup is open to healthcare organizations that are interested in implementing the post-acute orders/referral workflow.

Join the Post-Acute FHIR Orders Program

The CMS has completed and closed the EMDI pilot programs. Any new pilot applications will not be accepted. Providers, Document Transfer Vendors, EHRs, and Health IT systems willing to implement provider-to-provider interoperability can visit the EMDI Collaboration Website and Post-Acute Orders (PAO) Implementation Guide to find documentation, resources, and reference pilot findings for further guidance with interoperability implementations.


To find out more about this program, please visit the EMDI Collaboration Website.

Post-Acute FHIR Orders Program Resources

CMS Promoting Interoperability


CMS Documentation Requirement Lookup Service (DRLS)

EMDI Program

EMDI Collaboration Website

Page Last Modified:
01/24/2024 09:09 AM