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

Prescription Extension

In some situations, a caregiver needs to keep providing care for the same prescribed service beyond the validity period of the original prescription. eReferral supports this extension / prolongation use case.

To support this scenario, the model allows the creation of a new ServiceRequest that extends the original prescription.

Extending a Prescription

When a prescription’s validity period needs to be extended, a new ServiceRequest is created.

The new ServiceRequest references the original one using the standard FHIR relationship: ServiceRequest.replaces.

This allows the system to maintain a clear history of prescriptions while preserving the original clinical intent: the original ServiceRequest remains unchanged and represents the initial prescription created by the prescriber for its own validity period.

Role of the New ServiceRequest

The new ServiceRequest represents a new prescription to allow the continuation of care, covering a new validity period that follows on from the original prescription.

It keeps the same patient, requester, and prescribed service as the original prescription; only the validity period (and any administrative details tied to that period) differ.

Workflow Tracking

The workflow associated with the prescription is tracked using a new ReferralTask resource (generated by eReferral system).

The ReferralTask references the current active ServiceRequest through the Task.focus element.### Benefits of This Approach

Creating a new ServiceRequest instead of modifying the original one provides several advantages:

• preserves the original clinical prescription and its original validity period;
• maintains a clear audit trail of successive extensions;
• avoids ambiguity about which validity period was in force when care was executed.

This approach follows common FHIR workflow practices where continuation of care is represented through replaces relationships rather than in-place modification of the validity period.