v2.0.0 draft

eReferral Implementation Guide
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eReferral Implementation Guide, published by Riziv-Inami Platform. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/referral-uhmep/ and changes regularly. See the Directory of published versions

Annex 81 Medication Preparation

Prescription type code: medication-prefill-preparation-appendix-81.

Example: example-drp-nursing-med-preparation-appendix-81.

This table maps the business fields to the corresponding FHIR elements.

Business fields

Business field Values / constraints Data type Notes
Profile      
Intent     Must be “proposal” at creation of the annex 81.
Prescription type      
Discipline      
Validity period     Business validity of the prescription. (Period to at least start the treatment)
Patient     Value must follow pseudonymization rules.
Requester / prescriber     Reference to the prescribing practitioner role.
Reason - States difficulty cooperating with the prescribed treatment
- Confusion about the treatment
- Behaviour indicating that the patient does not adhere to treatment
- Medication taken only partially or not at all
- Persistence of complaints
- Progression of the disease process
- Occurrence of adverse effects
- Lack of support from family, friends, or social network		 List  
Treatment non-adherence related to: - Dementia (diagnosis of dementia made by a physician)
- Uncorrected visual function deficit
- Temporary motor impairment of one or both upper limbs
- Permanent motor impairment of one or both upper limbs
- Complex medication		 List  
Physician comment   String This field appears when the physician approves or rejects the annex 81.

FHIR mapping

Business field FHIR representation FHIR JSON example Terminology
Profile ServiceRequest.meta.profile 
{
  "meta": {
    "profile": [
      "https://www.riziv-inami.be/standards/fhir/ereferral/StructureDefinition/ereferral-annex-81"
    ]
  }
}
Intent ServiceRequest.intent 
{
  "intent": "proposal"
}
Prescription type ServiceRequest.category[prescriptionType] 
{
  "category": [
    {
      "coding": [
        {
          "system": "https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-prescription-type",
          "code": "medication-prefill-preparation-appendix-81"
        }
      ]
    }
  ]
}
Discipline ServiceRequest.category[discipline] 
{
  "category": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "9632001"
        }
      ]
    }
  ]
}
Validity period ServiceRequest.extension[validity] 
{
  "extension": [
    {
      "url": "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-validity-period",
      "valuePeriod": {
        "start": "2026-02-18",
        "end": "2027-02-18"
      }
    }
  ]
}
Patient ServiceRequest.subject 
{
  "subject": {
    "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": [
          {
            "url": "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization",
            "extension": [
              {
                "url": "marker",
                "valueBoolean": true
              },
              {
                "url": "format",
                "valueCode": "direct"
              },
              {
                "url": "version",
                "valuePositiveInt": 2
              }
            ]
          }
        ]
      }
    }
  }
}
Requester / prescriber ServiceRequest.requester 
{
  "requester": {
    "reference": "PractitionerRole/67120919457-NURSE"
  }
}
Reason ServiceRequest.reasonCode[nursingDiagnosis] 
{
  "reasonCode": [
    {
      "coding": [
        {
          "code": "708014007",
          "system": "http://snomed.info/sct"
        }
      ]
    }
  ]
}
Treatment non-adherence related to: ServiceRequest.reasonCode[medicalProblem] 
{
  "reasonCode": [
    {
      "coding": [
        {
          "code": "52448006",
          "system": "http://snomed.info/sct"
        }
      ]
    }
  ]
}
Physician comment ServiceRequest.note[general-remarks].text 
{
  "note": [
    {
      "text": "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}",
      "extension": [
        {
          "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-note-types",
                "code": "comment-prescriber"
              }
            ]
          }
        }
      ]
    }
  ]
}