# Translating 360X to FHIR
> **Open beta feature**
>
> This is an open beta feature, which means you won’t see it available in your organization until you opt in. If you’re interested in joining this beta, [talk to a Redoxer](https://redoxengine.com/forms/contact-us/) to find out if you’d be a good fit.
**DirectTrust** is an organization that provides a secure communication network and protocols to exchange healthcare data with your connections. Their **360 Exchange for Closed Loop Referrals** (**360X**) protocol enhances care coordination, improves patient outcomes, and increases operational efficiency for handling patient referrals. It allows real-time determination and communication with a provider, as well as offers scheduling for a follow-up appointment all through an automated workflow. [Learn more about 360X](https://directtrust.org/what-we-do/direct-secure-messaging/360x).
*Automated workflow for 360 Exchange for Closed Loop Referrals (360X)*
Redox translates standard **360X** messages between you and your connection, either to submit a referral to your connection or to act on a referral from your connection.
> **Key takeaways**
>
> - **360X** offers an enhanced, automated workflow to handle patient referrals.
> - Redox translates automated 360X messages to the relevant Redox FHIR writeback operation or Redox FHIR notification for both referring providers and responding specialists.
## Who needs to translate from 360X to FHIR
360X to FHIR translation is helpful for these use cases:
- A referring provider who wants to initiate patient referrals to a specialist.
- A specialist who wants to respond to patient referrals from a requesting provider.
## How 360X translation works
_For referring providers_: You send a referral request to Redox via standard 360X. Redox translates the data into a FHIR notification, which we push to the specialist.
_For specialists_: You receive FHIR notifications to begin acting on a referral request. Then you send FHIR writeback operations to Redox with updates about the referral. Redox translates the FHIR writeback operations to notifications for your connection.
We translate 360X data to FHIR notifications to power Redox API actions like these:
- [Receive a request for patient monitoring](/fhir-api-actions/order-and-enrollment/receive-a-request-for-patient-monitoring)
## Mappings between Redox FHIR writebacks and notifications
We translate standard 360X messages into Redox FHIR writeback operations or detailed FHIR notifications (i.e., no lightweight FHIR notifications available).
| **360X workflow** | **Redox FHIR writeback** | **Redox FHIR notification** |
| --- | --- | --- |
| Requestor initiates patient referral | (_For referring provider_) Redox translates your 360X patient referral to FHIR [`ServiceRequest$referral-request`](https://docs.redoxengine.com/permalink/0af3b872-1023-5826-9dd4-44bc3012b875-$referral-request) | (_For responding specialist_) Redox translates a referring provider's 360X patient referral to FHIR [`Order Referral Request`](https://docs.redoxengine.com/permalink/fc5345be-071d-5286-ae26-52c3299e0d8b-referral-requested) |
| Specialist accepts or rejects referral | (_For responding specialists_) Redox translates your 360X accept or decline to one of these FHIR writebacks: [`ServiceRequest$referral-accept`](https://docs.redoxengine.com/permalink/0af3b872-1023-5826-9dd4-44bc3012b875-$referral-accept) [`ServiceRequest$referral-decline`](https://docs.redoxengine.com/permalink/0af3b872-1023-5826-9dd4-44bc3012b875-$referral-decline) | (_For referring provider_) Redox translates a specialist's 360X accept or decline to one of these FHIR notifications: [`Order Referral Accepted`](https://docs.redoxengine.com/permalink/57d045a8-a041-54ab-9d58-d8ce65471625-referral-accepted) [`Order Referral Declined`](https://docs.redoxengine.com/permalink/f2d79036-0654-5202-a251-7ed49ca50d6f-referral-declined) |
| Referred appointment scheduled or updated | (_For responding specialists_) Redox translates your 360X new or updated appointment to FHIR [`Appointment$referral-schedule-update`](https://docs.redoxengine.com/permalink/7627871f-3512-5052-a8ee-5e2c1ccb2680-$referral-schedule-update) | (_For referring providers_) Redox translates a specialist's 360X new or updated appointment to FHIR [`Order Referral Schedule Updated`](https://docs.redoxengine.com/permalink/fec76211-0143-5005-aaa5-2d8af367a001-referral-schedule-updated) |
| Referred appointment cancelled | (_For referring providers_) Redox translates your 360X cancelled referral to FHIR [`ServiceRequest$referral-cancel`](https://docs.redoxengine.com/permalink/0af3b872-1023-5826-9dd4-44bc3012b875-$referral-cancel) (_For responding specialists_) Redox translates your 360X update or cancellation to the relevant FHIR writeback: [`ServiceRequest$referral-cancel-confirm`](https://docs.redoxengine.com/permalink/0af3b872-1023-5826-9dd4-44bc3012b875-$referral-cancel-confirm) | (_For referring providers_) Redox translates a specialist's 360X cancellation to FHIR [`Order Referral Confirm Cancelled`](https://docs.redoxengine.com/permalink/21841153-7bac-58b8-96f0-862ebe882ad0-referral-request-cancelled) |
| Post-visit summary | (_For responding specialists_) Redox translates your 360X visit summary to FHIR [`ServiceRequest$referral-complete`](https://docs.redoxengine.com/permalink/0af3b872-1023-5826-9dd4-44bc3012b875-$referral-complete) | (_For referring providers_) Redox translates a specialist's 360X visit summary to FHIR [`Order Referral Completed`](https://docs.redoxengine.com/permalink/77a0e106-6f63-5f8a-935d-2e0a9500b207-referral-completed) |