canonical: https://www.riziv-inami.be/standards/fhir/ereferral
url: https://www.riziv-inami.be/standards/fhir/ereferral/ImplementationGuide/inami.fhir.be.ereferral
fhirVersion: 4.0.1
FSHOnly: false
applyExtensionMetadataToRoot: false
id: inami.fhir.be.ereferral
name: EReferral
title: eReferral Implementation Guide
description: eReferral Implementation Guide
status: draft
date: 2026-09-02
version: 3.0.0
copyrightYear: 2026+
releaseLabel: STU
jurisdiction: urn:iso:std:iso:3166#BE "Belgium"
dependencies:
  hl7.fhir.be.core: 2.2.0
  #hl7.fhir.be.medication: 1.0.0
  hl7.fhir.be.core-clinical: 1.3.0
  #hl7.fhir.be.allergy: 1.1.0
  be.smals.fhir.drp-fix: current$drp-1.1.1-fixed
  hl7.fhir.be.infsec: 1.3.0

# The publisher can be a single item or a list, each with a name and
# optional url and/or email. The first publisher's name will be used
# as IG.publisher.  The contact details and/or additional publishers
# will be translated into IG.contact values.
publisher:
#  name: Smals Platform
  name: Riziv-Inami Platform
  url: https://www.riziv-inami.be/standards/fhir
  email: support-uhmep@smals.be

# ContactDetail is required by the template.
contact:
  - name: Message Structure Smals
    telecom:
      - system: email
        value: support-uhmep@smals.be
        use: work

# The pages property corresponds to IG.definition.page. SUSHI can
# auto-generate the page list, but if the author includes pages in
# this file, it is assumed that the author will fully manage the
# pages section and SUSHI will not generate any page entries.
# The page file name is used as the key. If title is not provided,
# then the title will be generated from the file name.  If a
# generation value is not provided, it will be inferred from the
# file name extension.  Any subproperties that are valid filenames
# with supported extensions (e.g., .md/.xml) will be treated as
# sub-pages.
pages:
  index.md:
    title: eReferral Implementation Guide
    generation: markdown
  guidance.md:
    title: Guidance
    generation: markdown
  migration-2-1-to-3-0.md:
    title: Migration 2.1.0 to 3.0.0
    generation: markdown
  topic-profiles-architecture.md:
    title: Profiles Architecture
    generation: markdown
  topic-profile-rewriting.md:
    title: Profile Rewriting
    generation: markdown
  topic-prescription-lifecycle.md:
    title: Life Cycle
    generation: markdown
    topic-prescription-lifecycle-proposal.md:
      title: Proposal Life Cycle
      generation: markdown
    topic-prescription-lifecycle-extension.md:
      title: Prescription Extension
      generation: markdown
  topic-prescription-templates.md:
    title: Prescription Templates
    generation: markdown
  topic-visibility-blacklisting.md:
    title: Visibility & Blacklisting
    generation: markdown
  api-integration.md:
    title: API Integration
    generation: markdown
  api-operations.md:
    title: API Operations
    generation: markdown
    operation-access-matrix.md:
      title: Access Matrix
      generation: markdown
    operation-create-medical-document.md:
      title: Create a Medical Document
      generation: markdown
    operation-consult-search-medical-documents.md:
      title: Consult or Search Medical Documents
      generation: markdown
    operation-complete-medical-document.md:
      title: Complete a Medical Document
      generation: markdown
    operation-cancel-medical-document.md:
      title: Cancel a Medical Document
      generation: markdown
    operation-assign-care-provider.md:
      title: Assign a Care Provider
      generation: markdown
    operation-unassign-care-provider.md:
      title: Unassign a Care Provider
      generation: markdown
    operation-record-execution-start.md:
      title: Record Execution Start
      generation: markdown
    operation-record-execution-end.md:
      title: Record Execution End
      generation: markdown
    operation-record-execution-interruption.md:
      title: Record Execution Interruption
      generation: markdown
    operation-cancel-execution.md:
      title: Cancel Execution
      generation: markdown
    operation-evaluate-proposal.md:
      title: Evaluate Proposal
      generation: markdown
    operation-evaluate-radiology-prescription.md:
      title: Evaluate Radiology Prescription
      generation: markdown
    api-complex-operations.md:
      title: Complex Operations
      generation: markdown
    error-codes.md:
      title: Error Codes
      generation: markdown
  mappings-business.md:
    title: Business Field Mappings
    generation: markdown
    mappings-nursing.md:
      title: Nursing
      generation: markdown
      mapper-nursing-generic.md:
        title: Generic Nursing
        generation: markdown
      mapper-nursing-bloodletting.md:
        title: Bloodletting
        generation: markdown
      mapper-nursing-chronic-dialysis.md:
        title: Chronic Dialysis
        generation: markdown
      mapper-nursing-diabetes-education-convention-center.md:
        title: Diabetes Education via Convention Centre
        generation: markdown
      mapper-nursing-diabetes-education-start-trajectory.md:
        title: Diabetes Education within Start Trajectory
        generation: markdown
      mapper-nursing-diabetes-education-care-trajectory.md:
        title: Diabetes Education within Care Trajectory
        generation: markdown
      mapper-nursing-diabetes-education-without-trajectory.md:
        title: Diabetes Education without Trajectory
        generation: markdown
      mapper-nursing-glycemic-test.md:
        title: Glycemic Test
        generation: markdown
      mapper-nursing-hygienic-care.md:
        title: Hygienic Care
        generation: markdown
      mapper-nursing-medication-prefill-not-refunded.md:
        title: Medication Prefill Preparation Not Refunded
        generation: markdown
      mapper-nursing-parameters.md:
        title: Parameters
        generation: markdown
      mapper-nursing-sampling.md:
        title: Sampling
        generation: markdown
      mapper-nursing-annex81-medication-preparation.md:
        title: Annex 81 Medication Preparation
        generation: markdown
    mappings-radiology.md:
      title: Radiology
      generation: markdown
      mapper-radiology-diagnostic-imaging.md:
        title: Diagnostic Imaging
        generation: markdown
  technical.md:
    title: Technical
    generation: markdown
  glossary.md:
    title: Glossary
    generation: markdown
  changes.md:
    title: Changes
    generation: markdown
  downloads.xml:
    title: Downloads
    generation: html
  
# The ImplementationGuide resource defines several other properties
# not represented above. These properties can be used as-is and
# should follow the format defined in ImplementationGuide:
# * meta
# * implicitRules
# * language
# * text
# * contained
# * extension
# * modifierExtension
# * experimental
# * useContext
# * copyright
# * packageId

# The menu property will be used to generate the input/menu.xml file.
# The menu is represented as a simple structure where the YAML key
# is the menu item name and the value is the URL. The IG publisher
# currently only supports one level deep on sub-menus.
# To provide a custom menu.xml file, do not include this property and
# include a `menu.xml` file in input/includes.
menu:
  Home: index.html
  Guidance: guidance.html
  Topics:
    Migration 2.1.0 to 3.0.0: migration-2-1-to-3-0.html
    Profiles Architecture: topic-profiles-architecture.html
    Profile Rewriting: topic-profile-rewriting.html
    Life Cycle: topic-prescription-lifecycle.html
    Prescription Templates: topic-prescription-templates.html
    Visibility & Blacklisting: topic-visibility-blacklisting.html
  API:
    Integration Rules: api-integration.html
    Operations: api-operations.html
    Access Matrix: operation-access-matrix.html
    Complex Operations: api-complex-operations.html
  Mappings:
    Overview: mappings-business.html
    Nursing: mappings-nursing.html
    Radiology: mappings-radiology.html
  Artifacts:
    Profiles: artifacts.html#structures-resource-profiles
    Extensions: artifacts.html#structures-extension-definitions
    Value Sets: artifacts.html#terminology-value-sets
    Code Systems: artifacts.html#terminology-code-systems
    Examples: artifacts.html#example-example-instances
  Technical: technical.html
  Resources:
    Glossary: glossary.html
    Downloads: downloads.html
    Changes: changes.html


parameters:
  shownav: 'true'
  apply-contact: 'true'
  apply-jurisdiction: 'true'
  apply-publisher: 'true'
  apply-version: 'true'
  # The Publisher currently cannot validate the complete local SNOMED supplement
  # when the Belgian edition is forced through path-expansion-params.
  # path-expansion-params: Parameters-terminology-expansion.json
  pin-canonicals: pin-multiples
  special-url:
    # Resources temporarily hosted in this IG pending their promotion to hl7.fhir.be.referral.
    - https://www.ehealth.fgov.be/standards/fhir/drp/StructureDefinition/be-ext-codeable-concept
    - https://www.ehealth.fgov.be/standards/fhir/drp/StructureDefinition/be-ext-radiology-supporting-info-role
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-pss-qsi-indications
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-radiology-supporting-info-role
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-diabetic-education-type-for-patients-without-trajectory
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-diabetic-education-type-with-trajectory
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-generic-care-types
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-glycemia-measurement-timing
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-note-types
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-prescription-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-session-types
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-diabetic-education-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-implant-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-imaging-modality
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-imaging-priority
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-request-track
    - https://www.ehealth.fgov.be/standards/fhir/terminology/CodeSystem/be-cs-pss-qsi-diagnostic-imaging-procedure
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-annex81-care-requested
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-annex81-medical-problem
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-annex81-nursing-diagnosis
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-annex81-technical-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-body-laterality
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-body-site
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-body-topography
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-categories-of-care
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-diabetes-education-identifier
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-education-type-with-trajectory
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-education-type-without-trajectory
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-educator-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-glycemia-measurement-time
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-note-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-nursing-care-requested
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-nursing-prescription-technical-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-parameter-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-sample-substance-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-session-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-session-type-extended
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-prescription-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-implant-type
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-imaging-modality
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-imaging-priority
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-request-track
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-pss-qsi-diagnostic-imaging-procedure
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-diagnostic-imaging-condition
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-diagnostic-imaging-procedure
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-hybrid-diagnostic-imaging-procedure
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-pss-qsi-indication
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/be-vs-radiology-supporting-info-role
    - https://www.ehealth.fgov.be/standards/fhir/terminology/ValueSet/ereferral-vs-imaging-patient-condition-indication

resources:
  ServiceRequest/example-drp-nursing-bloodletting:
    name: "Example: Bloodletting"
    description: |-
      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

  ServiceRequest/example-drp-nursing-chronic-dialysis:
    name: "Example: Chronic home dialysis"
    description: |
      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

  ServiceRequest/example-drp-nursing-de-convention-center:
    name: "Example: Diabetes education via convention centre"
    description: |
      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

  ServiceRequest/example-drp-nursing-de-within-care-trajectory:
    name: "Example: Diabetes education within care trajectory"
    description: |
      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

  ServiceRequest/example-drp-nursing-de-within-start-trajectory:
    name: "Example: Diabetes education within start trajectory"
    description: |
      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

  ServiceRequest/example-drp-nursing-de-without-care-trajectory:
    name: "Example: Diabetes education without care trajectory"
    description: |
      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

  ServiceRequest/example-drp-nursing-generic:
    name: "Example: Generic nursing care"
    description: |
      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

  ServiceRequest/example-drp-nursing-glycemic-test:
    name: "Example: Glycemic control with glucometer"
    description: |
      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

  ServiceRequest/example-drp-nursing-hygienic-care:
    name: "Example: Hygienic care"
    description: |
      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

  ServiceRequest/example-drp-nursing-med-prep-not-refunded:
    name: "Example: Preparation of medicines (not refunded)"
    description: |
      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

  ServiceRequest/example-drp-nursing-parameters:
    name: "Example: Measurement of parameters"
    description: |
      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

  ServiceRequest/example-drp-nursing-sampling:
    name: "Example: Sample collection"
    description: |
      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

  ServiceRequest/example-drp-nursing-med-preparation-appendix-81:
    name: "Example: Annex 81 - Preparing medication (proposal)"
    description: |
      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