{ "resourceType" : "ServiceRequest", "id" : "example-drp-clinical-imaging", "meta" : { "extension" : [{ "id" : "{{kid}}", "extension" : [{ "url" : "key", "valueString" : "urn:be:fgov:pseudo:v2:{{SEC1}}:{{transit-info}}", "_valueString" : { "extension" : [{ "extension" : [{ "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "direct" }, { "url" : "version", "valuePositiveInt" : 2 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization" }] } }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-key-pseudonymization" }], "profile" : ["https://www.riziv-inami.be/standards/fhir/ereferral/StructureDefinition/ereferral-servicerequest-diagnosticimaging"] }, "language" : "en", "text" : { "status" : "extensions", "div" : "

Generated Narrative: ServiceRequest example-drp-clinical-imaging

Profile: EReferralServiceRequestDiagnosticImaging

BeValidityPeriod: 2026-03-03 --> 2027-03-03

Request status reason: urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}

BePSSInfo: BePSSId/PSS-DRP-IMG-001

BeUrgencyJustification: urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}

status: Active

intent: Order

category: Diagnostic imaging (Appendix 82), Imaging, Ambulatory

priority: Urgent

code: Computed tomography of abdomen with contrast (procedure)

subject: Anonymous Patient (no stated gender), DoB:

authoredOn: 2026-03-03 10:15:00+0100

requester: PractitionerRole physician

reasonCode: urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}

supportingInfo:

bodySite:

Generated Narrative: QuestionnaireResponse #ci-attention-qr

Profile: EReferralImagingAttentionConditionsResponse

\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextDefinitionAnswer\"doco\"
\".\"\".\" ci-attention-qrQuestionnaire:Imaging Attention Conditions Questionnaire
\".\"\".\"\".\" implantsImplantsSNOMED CT: 40388003 (Implant)
\".\"\".\"\".\"\".\" implants-otherOther implant typeurn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}
\".\"\".\"\".\" pregnancyPregnancyfalse
\".\"\".\"\".\" diabetesDiabetesfalse
\".\"\".\"\".\" allergy-contrast-agentAllergy to contrast agenttrue
\".\"\".\"\".\" metallic-debrisMetallic debrisfalse
\".\"\".\"\".\" renal-dysfunctionRenal dysfunctionfalse
\".\"\".\"\".\" otherOtherurn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}
\".\"\".\"\".\" noneNonefalse

\"doco\" Documentation for this format

Generated Narrative: Patient #patient

Profile: BePatient version: 2.2.0

Anonymous Patient (no stated gender), DoB:

BeExtGenderAtBirthOther
" }, "contained" : [{ "resourceType" : "QuestionnaireResponse", "id" : "ci-attention-qr", "meta" : { "profile" : ["https://www.riziv-inami.be/standards/fhir/ereferral/StructureDefinition/ereferral-imaging-attention-conditions-response"] }, "questionnaire" : "https://www.ehealth.fgov.be/standards/fhir/referral/Questionnaire/be-questionnaire-imaging-attention-conditions", "status" : "completed", "authored" : "2026-03-03T10:15:00+01:00", "item" : [{ "linkId" : "implants", "text" : "Implants", "answer" : [{ "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "40388003" }, "item" : [{ "linkId" : "implants-other", "text" : "Other implant type", "answer" : [{ "valueString" : "urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}", "_valueString" : { "extension" : [{ "extension" : [{ "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "encrypted" }, { "url" : "version", "valuePositiveInt" : 1 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization" }] } }] }] }] }, { "linkId" : "pregnancy", "text" : "Pregnancy", "answer" : [{ "valueBoolean" : false }] }, { "linkId" : "diabetes", "text" : "Diabetes", "answer" : [{ "valueBoolean" : false }] }, { "linkId" : "allergy-contrast-agent", "text" : "Allergy to contrast agent", "answer" : [{ "valueBoolean" : true }] }, { "linkId" : "metallic-debris", "text" : "Metallic debris", "answer" : [{ "valueBoolean" : false }] }, { "linkId" : "renal-dysfunction", "text" : "Renal dysfunction", "answer" : [{ "valueBoolean" : false }] }, { "linkId" : "other", "text" : "Other", "answer" : [{ "valueString" : "urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}", "_valueString" : { "extension" : [{ "extension" : [{ "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "encrypted" }, { "url" : "version", "valuePositiveInt" : 1 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization" }] } }] }, { "linkId" : "none", "text" : "None", "answer" : [{ "valueBoolean" : false }] }] }, { "resourceType" : "Patient", "id" : "patient", "meta" : { "profile" : ["https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient|2.2.0"] }, "extension" : [{ "url" : "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-gender-at-birth", "valueCodeableConcept" : { "extension" : [{ "extension" : [{ "url" : "encryptedValue", "valueString" : "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}" }, { "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "encrypted" }, { "url" : "version", "valuePositiveInt" : 1 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymized-content" }], "coding" : [{ "system" : "http://hl7.org/fhir/administrative-gender", "code" : "other" }] } }], "_birthDate" : { "extension" : [{ "extension" : [{ "url" : "encryptedValue", "valueString" : "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}" }, { "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "encrypted" }, { "url" : "version", "valuePositiveInt" : 1 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymized-content" }] } }], "extension" : [{ "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-validity-period", "valuePeriod" : { "start" : "2026-03-03", "end" : "2027-03-03" } }, { "url" : "http://hl7.org/fhir/StructureDefinition/request-statusReason", "valueCodeableConcept" : { "text" : "urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}", "_text" : { "extension" : [{ "extension" : [{ "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "encrypted" }, { "url" : "version", "valuePositiveInt" : 1 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization" }] } } }, { "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-pss-info", "valueIdentifier" : { "system" : "https://www.ehealth.fgov.be/standards/fhir/pss/NamingSystem/pss-id", "value" : "PSS-DRP-IMG-001" } }, { "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-urgency-justification", "valueString" : "urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}", "_valueString" : { "extension" : [{ "extension" : [{ "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "encrypted" }, { "url" : "version", "valuePositiveInt" : 1 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization" }] } }], "status" : "active", "intent" : "order", "category" : [{ "coding" : [{ "system" : "https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-prescription-type", "code" : "diagnostic-imaging-appendix-82" }] }, { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "363679005" }] }, { "coding" : [{ "system" : "https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-request-track", "code" : "ambulatory" }] }], "priority" : "urgent", "code" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "32962002", "display" : "Computed tomography of abdomen with contrast (procedure)" }] }, "subject" : { "reference" : "#patient", "identifier" : { "use" : "official", "system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/ssin", "value" : "urn:be:fgov:pseudo:v2:{{SEC1}}:{{transit-info}}", "_value" : { "extension" : [{ "extension" : [{ "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "direct" }, { "url" : "version", "valuePositiveInt" : 2 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization" }] } } }, "authoredOn" : "2026-03-03T10:15:00+01:00", "requester" : { "reference" : "PractitionerRole/72101230445-PHYSICIAN" }, "reasonCode" : [{ "text" : "urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}", "_text" : { "extension" : [{ "extension" : [{ "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "encrypted" }, { "url" : "version", "valuePositiveInt" : 1 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization" }] } }], "supportingInfo" : [{ "extension" : [{ "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-radiology-supporting-info-role", "valueCode" : "prior-request" }], "reference" : "ServiceRequest/example-prior-drp-clinical-imaging" }, { "extension" : [{ "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-radiology-supporting-info-role", "valueCode" : "prior-request" }, { "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-codeable-concept", "valueCodeableConcept" : { "coding" : [{ "system" : "https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-imaging-modality", "code" : "ct", "display" : "CT" }] } }], "display" : "Coded prior imaging request" }, { "extension" : [{ "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-radiology-supporting-info-role", "valueCode" : "patient-condition" }, { "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-codeable-concept", "valueCodeableConcept" : { "coding" : [{ "system" : "https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-pss-qsi-indications", "code" : "2506", "display" : "AAA screening, family history of AAA" }] } }], "display" : "Coded patient condition" }, { "extension" : [{ "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-radiology-supporting-info-role", "valueCode" : "patient-condition" }, { "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-codeable-concept", "valueCodeableConcept" : { "text" : "urn:be:fgov:pseudo:v1:{{kid}}:{{jwe}}", "_text" : { "extension" : [{ "extension" : [{ "url" : "marker", "valueBoolean" : true }, { "url" : "format", "valueCode" : "encrypted" }, { "url" : "version", "valuePositiveInt" : 1 }], "url" : "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization" }] } } }], "display" : "Free-text patient condition" }, { "extension" : [{ "url" : "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-radiology-supporting-info-role", "valueCode" : "safety-checklist" }], "reference" : "#ci-attention-qr" }], "bodySite" : [{ "extension" : [{ "url" : "https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality", "valueCoding" : { "system" : "http://snomed.info/sct", "code" : "24028007", "display" : "Right" } }] }] }