v2.0.0 draft

eReferral Implementation Guide
2.0.0 - Belgium flag

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

Chronic Dialysis

Prescription type code: chronic-dialysis.

Example: example-drp-nursing-chronic-dialysis.

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

Business fields

Business field Values / constraints Data type Notes
Prescription type      
Discipline      
Validity period     Business validity of the prescription.
Patient     SSIN identifier; value must follow pseudonymization rules.
Requester / prescriber     Reference to the prescribing practitioner role.
Diagnosis … String Required in business template. Free text diagnosis; must be encrypted with a pseudonymized key.
Frequency     Required in business template. Timing repeat block.
- Number of repetitions … times per Integer Number of repetitions per period.
- Time unit - Day
- Week
- Month		 Enum  
Treatment period     Required in business template. Overall treatment period.
- Duration … Integer Duration value.
- Time unit - Day(s)
- Week(s)
- Month		 Enum  
Number of sessions (max) … Integer Required in business template. Total number of planned sessions.
Medical reason … (field becomes mandatory when frequency is more than once per day) String Medical reason; coded value when available, otherwise pseudonymized text.
Contraindications … String Free text; must be encrypted with a pseudonymized key.
General remarks … String Free text; must be encrypted with a pseudonymized key.
Medical reason … String Medical reason; coded value when available, otherwise pseudonymized text.
Feedback required - Yes
- No		 Boolean Required in business template. be-ext-feedback-to-prescriber.
Validity start date Today (default) Date Required in business template. be-ext-validity-period.

FHIR mapping

Business field FHIR representation FHIR JSON example Terminology
Prescription type ServiceRequest.category[prescriptionType] 
{
  "category": [
    {
      "coding": [
        {
          "system": "https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-prescription-type",
          "code": "chronic-dialysis"
        }
      ]
    }
  ]
}
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"
      }
    }
  ]
}
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/72101230445-PHYSICIAN"
  }
}
Diagnosis ServiceRequest.reasonCode.text 
{
  "reasonCode": [
    {
      "text": "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}",
      "_text": {
        "extension": [
          {
            "url": "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization",
            "extension": [
              {
                "url": "marker",
                "valueBoolean": true
              },
              {
                "url": "format",
                "valueCode": "encrypted"
              },
              {
                "url": "version",
                "valuePositiveInt": 1
              }
            ]
          }
        ]
      }
    }
  ]
}
Frequency ServiceRequest.occurrenceTiming.repeat 
{
  "occurrenceTiming": {
    "repeat": {
      "boundsDuration": {
        "value": 2,
        "system": "http://unitsofmeasure.org",
        "code": "mo"
      },
      "count": 9,
      "frequency": 1,
      "period": 1,
      "periodUnit": "wk"
    }
  }
}
- Number of repetitions ServiceRequest.occurrenceTiming.repeat.frequency 
{
  "occurrenceTiming": {
    "repeat": {
      "frequency": 1
    }
  }
}
- Time unit ServiceRequest.occurrenceTiming.repeat.periodUnit 
{
  "occurrenceTiming": {
    "repeat": {
      "periodUnit": "wk"
    }
  }
}
Treatment period ServiceRequest.occurrenceTiming.repeat.boundsDuration 
{
  "occurrenceTiming": {
    "repeat": {
      "boundsDuration": {
        "value": 2,
        "system": "http://unitsofmeasure.org",
        "code": "mo"
      }
    }
  }
}
- Duration ServiceRequest.occurrenceTiming.repeat.boundsDuration.value 
{
  "occurrenceTiming": {
    "repeat": {
      "boundsDuration": {
        "value": 2
      }
    }
  }
}
- Time unit ServiceRequest.occurrenceTiming.repeat.periodUnit 
{
  "occurrenceTiming": {
    "repeat": {
      "periodUnit": "wk"
    }
  }
}
Number of sessions (max) ServiceRequest.occurrenceTiming.repeat.count 
{
  "occurrenceTiming": {
    "repeat": {
      "count": 9
    }
  }
}
Medical reason ServiceRequest.reasonCode 
{
  "reasonCode": [
    {
      "text": "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}",
      "_text": {
        "extension": [
          {
            "url": "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization",
            "extension": [
              {
                "url": "marker",
                "valueBoolean": true
              },
              {
                "url": "format",
                "valueCode": "encrypted"
              },
              {
                "url": "version",
                "valuePositiveInt": 1
              }
            ]
          }
        ]
      }
    }
  ]
}
Contraindications ServiceRequest.note[contraindication].text 
{
  "note": [
    {
      "extension": [
        {
          "url": "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-note-types",
                "code": "contraindication"
              }
            ]
          }
        }
      ],
      "text": "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}",
      "_text": {
        "extension": [
          {
            "url": "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization",
            "extension": [
              {
                "url": "marker",
                "valueBoolean": true
              },
              {
                "url": "format",
                "valueCode": "encrypted"
              },
              {
                "url": "version",
                "valuePositiveInt": 1
              }
            ]
          }
        ]
      }
    }
  ]
}
General remarks ServiceRequest.note[general-remarks].text 
{
  "note": [
    {
      "extension": [
        {
          "url": "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-note-types",
                "code": "general-remarks"
              }
            ]
          }
        }
      ],
      "text": "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}",
      "_text": {
        "extension": [
          {
            "url": "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization",
            "extension": [
              {
                "url": "marker",
                "valueBoolean": true
              },
              {
                "url": "format",
                "valueCode": "encrypted"
              },
              {
                "url": "version",
                "valuePositiveInt": 1
              }
            ]
          }
        ]
      }
    }
  ]
}
Medical reason ServiceRequest.reasonCode 
{
  "reasonCode": [
    {
      "text": "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}",
      "_text": {
        "extension": [
          {
            "url": "https://www.ehealth.fgov.be/standards/fhir/infsec/StructureDefinition/be-ext-pseudonymization",
            "extension": [
              {
                "url": "marker",
                "valueBoolean": true
              },
              {
                "url": "format",
                "valueCode": "encrypted"
              },
              {
                "url": "version",
                "valuePositiveInt": 1
              }
            ]
          }
        ]
      }
    }
  ]
}
Feedback required ServiceRequest.extension[feedback] 
{
  "extension": [
    {
      "url": "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-feedback-to-prescriber",
      "valueBoolean": true
    }
  ]
}
Validity start date ServiceRequest.extension[validity] 
{
  "extension": [
    {
      "url": "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-validity-period",
      "valuePeriod": {
        "start": "2026-02-18"
      }
    }
  ]
}