## Update a clinical reference

`auto_scribe.clinical_references.update(strclinical_reference_id, ClinicalReferenceUpdateParams**kwargs)  -> ClinicalReference`

**patch** `/v1/autoScribe/clinicalReferences/{clinicalReferenceId}`

Updates name, metadata, and Express customer assignment. Type is immutable after create.

### Parameters

- `clinical_reference_id: str`

  Unique clinical reference identifier. Format: ref_{32-hex-chars}

- `express_customer_id: Optional[str]`

- `metadata: Optional[Dict[str, str]]`

- `name: Optional[str]`

### Returns

- `class ClinicalReference: …`

  A canonical clinical reference value for study workflow pickers and normalization

  - `clinical_reference_id: str`

    Unique clinical reference identifier. Format: ref_{32-hex-chars}

  - `created_at: Optional[datetime]`

    Timestamp when the clinical reference was created

  - `is_active: bool`

    Whether this reference is active and available for pickers

  - `name: str`

    Canonical display name for this reference value

  - `type: ClinicalReferenceType`

    Category of canonical clinical reference value used for study workflow pickers and normalization.

    - `"facility"`

    - `"referring_provider"`

    - `"study_description"`

    - `"procedure"`

  - `updated_at: Optional[datetime]`

    Timestamp when the clinical reference was last updated

  - `express_customer: Optional[ExpressCustomerReference]`

    A reference to an Express customer with basic identifying information

    - `express_customer_id: str`

      Unique Express customer identifier. Format: cus_{32-hex-chars}

    - `express_customer_name: str`

      Name of the Express customer

  - `external_reference_id: Optional[str]`

    Integrator-provided stable identifier for mapping inbound data

  - `metadata: Optional[Dict[str, str]]`

    Optional key-value metadata. Maximum 50 pairs

### Example

```python
import os
from avara import Avara

client = Avara(
    api_key=os.environ.get("AVARA_API_KEY"),  # This is the default and can be omitted
)
clinical_reference = client.auto_scribe.clinical_references.update(
    clinical_reference_id="ref_1234567890abcdef1234567890abcdef",
)
print(clinical_reference.clinical_reference_id)
```

#### Response

```json
{
  "clinicalReferenceId": "ref_1234567890abcdef1234567890abcdef",
  "createdAt": "2024-01-15T09:00:00Z",
  "isActive": true,
  "name": "City Medical Center",
  "type": "facility",
  "updatedAt": "2024-03-15T14:20:00Z",
  "expressCustomer": {
    "expressCustomerId": "cus_1234567890abcdef1234567890abcdef",
    "expressCustomerName": "City Medical Center"
  },
  "externalReferenceId": "FAC-001",
  "metadata": {
    "region": "northeast"
  }
}
```