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

Sampling

Prescription type code: sampling.

Example: example-drp-nursing-sampling.

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.
Sample type - Sputum
- Urine
- Blood
- Stool
- Nasal fluid
- Saliva
- Other		 List  
This field appears when “Sample type” = “Other”      
Other: … String Required in business template. Conditional free text for “other”; must be encrypted with a pseudonymized key.
Body location - Posterior region of head
- Occipital condyle structure
- Temporal lobe
- … (see list below the table)		 List ServiceRequest.bodySite base coding (SNOMED). Compare business values with current ValueSets before finalizing.
Body laterality - Left
- Right
- Bilateral		 List ServiceRequest.bodySite.extension:laterality (be-ext-laterality).
Body topography - Top
- Bottom
- Medial
- Lateral
- Superior
- Inferior
- Posterior/rear
- Anterior/front
- Below
- Above
- Internal
- External		 List ServiceRequest.bodySite.extension:topography (be-ext-body-topography). Note: this extension’s formal FHIR context does not list ServiceRequest.bodySite explicitly (only Condition/Observation/DeviceUseStatement/Procedure.bodySite); to be validated against the IG Publisher build.
Diagnosis … String Required in business template. Free text diagnosis; must be encrypted with a pseudonymized key.
Sampling nature - Single sampling
- Recurring sampling		 Enum Compare business values with current ValueSets before finalizing.
These fields appear only when “Sampling nature” = “Recurring sampling”     No direct mapping inferred automatically from the business label.
Frequency     Required in business template. Timing repeat block.
- Number of repetitions … times per Integer Number of repetitions per period.
- Time unit - Day
- Week
- Month
- An		 Enum  
Treatment period     Required in business template. Overall treatment period.
- Duration … Integer Duration value.
- Time unit - Day(s)
- Week(s)
- Month
- Year(s)		 Enum  
Number of sessions (max) - …
- (if “sampling nature” = “single sampling”, the number of sessions is 1; otherwise, the number of sessions should be calculated automatically from the frequency and treatment period)		 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.
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.

Body location values (see SNOMED codes table below): Head, Eye, Ear, Mouth, Nose, External naris, Lip, Cheek, Chest, Abdomen, Entire back, Upper limb, Forearm, Elbow, Hand, Shoulder, Leg, Tibia, Knee, Thigh, Greater trochanter, Fibula, Fibular malleolus structure, Entire calf of leg, Malleolar region, Ankle, Heel, Skin of instep, Foot, Big toe, Toe: 2nd, Toe: 3rd, Toe: 4th, Toe: 5th, Scapula, Ischium, Entire iliac crest, Penis, Vagina, Anus, Forehead, Facial structure, Neck, Thumb, Index finger, Middle finger, Ring finger, Little finger, Hip, Sacrum, Pubis.

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": "sampling"
        }
      ]
    }
  ]
}
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"
  }
}
Sample type ServiceRequest.orderDetail 
{
  "orderDetail": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "78014005"
        }
      ]
    }
  ]
}
This field appears when "Sample type" = "Other" ServiceRequest.orderDetail 
{
  "orderDetail": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "78014005"
        }
      ]
    }
  ]
}
Other: CodeableConcept.text 
{
  "text": "urn:be:fgov:pseudo-encrypted:v1:{{kid}}:{{jwe}}"
}
Body location ServiceRequest.bodySite 
{
  "bodySite": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "78277001"
        }
      ]
    }
  ]
}
Body laterality ServiceRequest.bodySite.extension:laterality 
{
  "bodySite": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "78277001"
        }
      ],
      "extension": [
        {
          "url": "https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality",
          "valueCoding": {
            "system": "http://snomed.info/sct",
            "code": "24028007"
          }
        }
      ]
    }
  ]
}
Body topography ServiceRequest.bodySite.extension:topography 
{
  "bodySite": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "78277001"
        }
      ],
      "extension": [
        {
          "url": "https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-body-topography",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "255561001"
              }
            ]
          }
        }
      ]
    }
  ]
}
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
              }
            ]
          }
        ]
      }
    }
  ]
}
Sampling nature Coded field; mapping to be confirmed
These fields appear only when "Sampling nature" = "Recurring sampling" To be confirmed
Frequency ServiceRequest.occurrenceTiming.repeat 
{
  "occurrenceTiming": {
    "repeat": {
      "count": 1
    }
  }
}
- Number of repetitions ServiceRequest.occurrenceTiming.repeat.frequency 
{
  "occurrenceTiming": {
    "repeat": {
      "count": 1
    }
  }
}
- Time unit ServiceRequest.occurrenceTiming.repeat.periodUnit 
{
  "occurrenceTiming": {
    "repeat": {
      "count": 1
    }
  }
}
Treatment period ServiceRequest.occurrenceTiming.repeat.boundsDuration 
{
  "occurrenceTiming": {
    "repeat": {
      "count": 1
    }
  }
}
- Duration ServiceRequest.occurrenceTiming.repeat.boundsDuration.value 
{
  "occurrenceTiming": {
    "repeat": {
      "count": 1
    }
  }
}
- Time unit ServiceRequest.occurrenceTiming.repeat.periodUnit 
{
  "occurrenceTiming": {
    "repeat": {
      "count": 1
    }
  }
}
Number of sessions (max) ServiceRequest.occurrenceTiming.repeat.count 
{
  "occurrenceTiming": {
    "repeat": {
      "count": 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
              }
            ]
          }
        ]
      }
    }
  ]
}
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": [
    {
      "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": "general-remarks"
              }
            ]
          }
        }
      ]
    }
  ]
}
Feedback required ServiceRequest.extension[feedback] 
{
  "extension": [
    {
      "url": "https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-feedback-to-prescriber",
      "valueBoolean": false
    }
  ]
}
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"
      }
    }
  ]
}