Minutes - Referral WG 2021-03-18

Attendees

• Andries Nelissen
• Arnaud Lippert
• Bruno Casneuf
• Erwin Bellon
• Jean-Michel Polfliet
• José Costa Teixeira
• Karlien Erauw
• Nick Hermans
• Pieter Devolder
• Robin Bosman
• Robin Decoster
• Sander Van den Wyngaert
• Wouter Huysse

Excused

• Elfi Goessaert
• Karen Anthonissen
• Katleen Smedts
• Tom Deprez

Agenda

• Review of the updated datamodel and technical FHIR artefact
• Review of example on modalities
• Further take-up in other organisations

Minutes

• Andries is involved in the European working group op cross border exchange of medical imaging & dismissal form, project leader for FOD Volksgezondheid. This project is an extension of the CEF project that includes the summary & eprescription and is now also looking f.e. in the lab results. Andries is involved in the functional part.
• Robin presents the

• modifierExtension: obligatory to pass on, v3-NullFlavor can be given, example of null flavor: asked but unknown (ASKU)

• Null Flavors is HL7 concept, see values: https://terminology.hl7.org/2.1.0/CodeSystem-v3-NullFlavor.html

• modifierExtension BeContrastFluidUse, see http://build.fhir.org/ig/hl7-be/hl7-be-fhir-referral-prescription/ValueSet-be-contrastfluid-use.html having 2 values
• reasonCode element
• see examples: http://build.fhir.org/ig/hl7-be/hl7-be-fhir-referral-prescription/ServiceRequest-diagnostic-imaging-basic-example-concreteWithDetails.xml.html

• the Belgian FHIR profile for vaccination has been used to influence the FHIR profile at European level

• Erwin has composed a list with questions that mainly need to be answered by the politics
• Review of the updated datamodel after the discussion in the previous WG ; unfortunately there was a technical issue with the publication

• logical model has been cleaned, heritage from BeReferralPrescription
• diagnostic questioning
• extension for codeable concept
• modifier extension for contra indication as it is important ; with its own structure and preferrably expressed as a structure
• supporting info: goal is that only relevant information is sent in the referral

• Should/shall we enforce for Acquisition Modality: http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html

• Clarification by RIZIV: the referrals will be active and identical intramuros and extramuros

• however if intramuros there are additional requests, it would be fine as long as it fits in the general model
• for complex cases it might be difficult to capture all the details in the referral (f.e. 3D modelling for surgery)
• intramuros there are detailed modules for medical imaging
• a good balance will have to be sought here to avoid that we keep discusssing for years

• Robin will finalise the technical structure to finish the medical imaging referral

• can we move to a federal standard ? We will have to go through a formal request, then through the WGSE (WG Structural Elements) and the eHealth Program Board

Date Next Meeting : April 1 at 4PM which will be the final meeting re. Medical Imaging referral Action point:

• Karlien should ask for 45/60minute slot to present to 3 associations: BVR, Belg vereniging voor Nuclaire geneeskunde, BELMIP ?Karlien to take action here