Comment:

The 360X Project has found it immensly helpful to explicitly prescribe how the Patient.idenitfier needs to be used. Since all interactions start with the referral request, it shall contain the Patient.identifier known to the referral initiator. This identifier shall be used in all subsequent messages related to this referral. Other identifiers may be used in addition to the identifier known to the referral initiator.

Summary:

360x Consistency