What is a referral order, @PriyaDesai? A request inside the EHR from somebody to somebody to refer the patient along?
Generally, we are not modeling organizational transactions inside the institutions. All the scheduling, back and forth between providers, all that is irrelevant. Only medical facts are needed. The reason we are talking orders here is because often drug exposure is only visible through e-prescribing or e-ordering tools. But the plan to refer somebody is not a clinical event. If the patient actually leaves and moves to another institution you store that in the discharge_to_concept_id field of the VISIT_OCCURRENCE table.