Referral of patient from primary to secondary care using push technology

Scenario context: 

In this Realisation Scenario, the GP knows to which specialist he is going to refer the patient. He/she sends a request for further treatment, the reason for referral, and a patient summary to the selected specialist through a secure point to point connection 

Secondary Care EHR System (specialist)
Primary Care EHR System (general physician)
Generate Summary (discharge letter)
Send Document
Technical Process Flow: 
  1. Secondary Care EHR System generates a discharge letter and shows this in editable form to the specialist
  2. Specialist edits the automatically generated document
  3. Specialist saves the Referral letter
  4. The Secondary Care EHR System sends the discharge letter to the Primary Care EHR System of the referring GP 
Possible issues: 

The automatically generated content of the referral letter may contain structured and coded elements that are defined on the national/regional level.