v2.1.0 draft

eReferral Implementation Guide
2.1.0 - Belgium flag

eReferral Implementation Guide, published by Riziv-Inami Platform. This guide is not an authorized publication; it is the continuous build for version 2.1.0 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

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

EReferralAnnex81

Annex81 proposal and approval

EReferralImagingAttentionConditionsResponse

eReferral response to the imaging attention conditions questionnaire.

EReferralServiceRequestDiagnosticImaging

The diagnostic imaging profile. eReferral version.

EReferralServiceRequestNursing

The nursing profile, generic version. Please note the nursing referral for medication does NOT depend on this generic version but is a FHIR prodfile on a different FHIR resource (MedicationRequest)

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

CodeableConcept Extension for Reference

Extension able to hold a coded concept on a Reference element.

eReferral Radiology SupportingInfo Role

Identifies the role of a ServiceRequest.supportingInfo entry used in a diagnostic imaging referral.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

PSS/QSI Indication

Indication codes for diagnostic imaging requests as PSS Internal Codes.

SNOMED CT eReferral Supplement Designations

SNOMED CT supplement containing multilingual designations maintained for the eReferral project.

eReferral Imaging Patient Condition Indication

Allowed coded indications for patient condition in diagnostic imaging.

eReferral Radiology SupportingInfo Role ValueSet

Allowed roles for entries in ServiceRequest.supportingInfo in a diagnostic imaging referral.

eReferral/PSS Diagnostic Imaging Condition

Clinical conditions that can support a diagnostic imaging request using SNOMED CT.

eReferral/PSS Diagnostic Imaging Procedure

Diagnostic care services that can be prescribed for diagnostic imaging using SNOMED CT.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

PSS Indication

PSS indication codes for diagnostic imaging requests.

PSS/QSI Diagnostic Imaging Procedure

PSS/QSI diagnostic imaging procedure codes with English displays and Belgian French, Dutch and German designations.

SNOMED CT eReferral Supplement Designations

SNOMED CT supplement containing multilingual designations maintained for the eReferral project.

eReferral Designation Use

Identifies terminology designations maintained specifically for the eReferral project.

eReferral Radiology SupportingInfo Role CodeSystem

Identifies the role represented by an entry in ServiceRequest.supportingInfo for a diagnostic imaging referral.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Example: Annex 81 - Preparing medication (proposal)

Example of an Annex 81 ServiceRequest proposal for preparing medication.

Inputs and values used in this example:

  • Profile: be-annex-81
  • Intent: proposal
  • Prescription type: medication-prefill-preparation-appendix-81
  • Procedure code (SNOMED): 385796006
  • Validity period: 2026-02-18 - 2027-02-18
  • Requester role: nurse (PractitionerRole/67120919457-NURSE)
  • Indications (reasonCode - 13 SNOMED codes):
    • 1290542000
    • 129834002
    • 271299001
    • 275928001
    • 359748005
    • 448176008
    • 62014003
    • 708014007
    • 1137439008
    • 211071000172100
    • 211101000172107
    • 397540003
    • 52448006
Example: Bloodletting

Example of therapeutic bloodletting including quantity.

Inputs and values used in this example:

  • Prescription type: bloodletting
  • Procedure code (SNOMED): 127606004
  • Quantity: 300 mL
  • Validity start date: 2026-02-18
  • Timing:
    • boundsDuration: 1 week
    • count: 3
    • frequency: 3
    • period: 1 week
  • Medical reason (SNOMED): 404684003
  • Notes:
    • medical-reason
Example: Chronic home dialysis

Example of chronic home dialysis prescription.

Inputs and values used in this example:

  • Prescription type: chronic-dialysis
  • Procedure code (SNOMED): 225230008
  • Validity start date: 2026-02-18
  • Timing:
    • boundsDuration: 2 months
    • count: 9
    • frequency: 1
    • period: 1 week
  • Feedback to prescriber: true
  • Medical reason (SNOMED): 404684003
  • Notes:
    • medical-reason
    • contraindication
    • general-remarks
Example: Diabetes education via convention centre

Example of diabetes education delivered through a convention centre.

Inputs and values used in this example:

  • Prescription type: diabetic-education-convention-center
  • Education code (SNOMED): 385805005
  • Education subtype (SNOMED): 211141000172109
  • Education type: diabetic-education-other
  • Validity period: 2026-02-18 - 2027-02-18
  • Timing:
    • boundsDuration: 4 months
    • count: 52
    • frequency: 3
    • period: 1 week
  • Feedback to prescriber: false
  • Notes:
    • general-remarks
Example: Diabetes education within care trajectory

Example of diabetes education within an established care pathway.

Inputs and values used in this example:

  • Prescription type: diabetic-education-within-care-trajectory
  • Education code (SNOMED): 385805005
  • Education subtype (SNOMED): 370858005
  • Education type: diabetic-education-additional-hba1c
  • Session type: group-session
  • Performer types (SNOMED):
    • 106292003
    • 224543004
  • Validity period: 2026-02-18 - 2026-12-31
  • Number of sessions: 5
Example: Diabetes education within start trajectory

Example of diabetes education within a start trajectory.

Inputs and values used in this example:

  • Prescription type: diabetic-education-within-start-trajectory
  • Education code (SNOMED): 385805005
  • Education subtype (SNOMED): 211151000172106
  • Session type: individual-session
  • Validity period: 2026-02-18 – 2026-12-31
  • Number of sessions (count): 4
  • Performer type (SNOMED): 224543004
  • Feedback to prescriber: false
  • Notes:
    • general-remarks
Example: Diabetes education without care trajectory

Example of diabetes education for patients without a care trajectory.

Inputs and values used in this example:

  • Prescription type: diabetic-education-without-care-trajectory
  • Education code (SNOMED): 385805005
  • Education subtype (SNOMED): 211161000172108
  • Education type: diabetic-education-self-care
  • Validity start date: 2026-02-18
  • Timing:
    • boundsDuration: 3 weeks
    • count: 21
    • frequency: 1
    • period: 1 day
  • Feedback to prescriber: true
  • Notes:
    • general-remarks
Example: Diagnostic imaging referral

Example of a diagnostic imaging referral prescription with contained patient and imaging attention questionnaire response.

Example: Generic nursing care

Example of a generic nursing ServiceRequest.

Inputs and values used in this example:

  • Prescription type: generic-nursing
  • Care code (SNOMED): 9632001
  • Care detail (orderDetail): preparation-and-administration-of-medication-for-psychiatric-patient
  • Validity start date: 2026-02-18
  • Timing:
    • boundsDuration: 4 months
    • count: 360
    • frequency: 3
    • period: 1 day
  • Priority: routine
  • Feedback to prescriber: false
  • Medical reason (SNOMED): 404684003
  • Notes:
    • medical-reason
    • contraindication
    • general-remarks
Example: Glycemic control with glucometer

Example of glycemic monitoring using a glucometer.

Inputs and values used in this example:

  • Prescription type: glycemic-test
  • Procedure code (SNOMED): 166900001
  • Measurement timing: before-insulin-administration
  • Validity start date: 2026-02-18
  • Timing:
    • boundsDuration: 3 weeks
    • count: 21
    • frequency: 1
    • period: 1 day
  • Medical reason (SNOMED): 404684003
  • Notes:
    • medical-reason
    • contraindication
    • general-remarks
Example: Hygienic care

Example of hygienic nursing care.

Inputs and values used in this example:

  • Prescription type: hygienic-care
  • Procedure code (SNOMED): 225964003
  • Validity start date: 2026-02-18
  • Timing:
    • boundsDuration: 3 months
    • count: 39
    • frequency: 3
    • period: 1 week
  • Notes:
    • medical-reason
Example: Measurement of parameters

Example of clinical parameter monitoring.

Inputs and values used in this example:

  • Prescription type: parameters
  • Procedure code (SNOMED): 61746007
  • Parameter detail (SNOMED): 431314004
  • Validity start date: 2026-02-18
  • Timing:
    • boundsDuration: 2 months
    • count: 180
    • frequency: 3
    • period: 1 day
    • when: C
  • Medical reason (SNOMED): 404684003
  • Notes:
    • medical-reason
Example: Preparation of medicines (not refunded)

Example of non-reimbursed medication prefill preparation.

Inputs and values used in this example:

  • Prescription type: medication-prefill-preparation-not-refunded
  • Procedure code (SNOMED): 385796006
  • Validity period: 2026-02-18 – 2027-02-18
  • Timing:
    • frequency: 3
    • period: 1 week
  • Medical reason (SNOMED): 404684003
  • Notes:
    • contraindication
    • general-remarks
Example: Prior diagnostic imaging referral

A complete prior diagnostic imaging prescription referenced by the main diagnostic imaging example.

Example: Sample collection

Example of a biological sample collection prescription.

Inputs and values used in this example:

  • Prescription type: sampling
  • Procedure code (SNOMED): 17636008
  • Sampling detail (SNOMED): 78014005
  • Occurrence count: 1
  • Validity start date: 2026-02-18
  • Medical reason (SNOMED): 404684003
  • Notes:
    • medical-reason
    • contraindication
Nurse

Example practitioner acting as a nurse.

Nurse Requester

Nurse acting as a Requester

Physician

Example practitioner acting as a requesting physician.

Physician Requester

Physician acting as a Requester

Urgency Physician Requester

Urgency Physician acting as a Requester

Other

These are resources that are used within this implementation guide that do not fit into one of the other categories.

ereferral-referral-task

Example referral task associated with a nursing prescription.