Used Documentation

Cookbook	Version	Location
Therapeutic Link WS Cookbook	1.6	https://www.ehealth.fgov.be/ehealthplatform/nl/service-ehealth-therapeutic-links

General Information

Therapeutic Links

Management of the Therapeutic Links:

The eHealth consent WA will allow both patients (incl. patient's parents or mandataries) and authorized HC parties to manage the therapeutic links (declaration, revocation and consultation)
The authorized HC parties, citizin (incl. concerned patients, parents of patients or patient's mandataries) are also able to perform the same operations throughout their usual software by calling the eHealth therapeutic link WS.
The authorized HC organizations are only authorized to verify the existence of the therapeutic links before allowing the HC parties ti access the medical data of the patients by calling the therapeutic link consultation WS through their application.

The existence of a therapeutic relation is one of the fundamental prerequisites for the healthcare (HC) providers to access a patient’s medical data. Therefore, the eHealth platform makes available to the actors
involved in the exchange, storage or referencing personal data, a relay service to manage those therapeutic relations and associated means of evidence.

This relay service is obviously limited to kinds of therapeutic links made available at the eHealth platform level by the ‘owner’ of this therapeutic link (such as the HC party declaring a therapeutic link or the actor responsible
of a recognized specific database, e.g. for Global Medical File relation). A therapeutic link is a relation between a patient and a HC party for a certain type of therapeutic
relation over a period of validity depending on the given evidence. It is not possible to update an existing the therapeutic link; to update information you first need to revoke the existing therapeutic link.

However, the period of validity of an active therapeutic link could be extended on the condition that

The start date of the new period is greater or equal to the start date of the period to be extended
The end date of the new period is greater than the end date of the period to be extended (overlap of period of validity)

The following operations (request-response operation type) will support the management of these links:

PutTherapeuticLink	Used to declare the therapeutic links. Its main purpose is to allow one to declare a therapeutic link.
RevokeTherapeuticLink	Used to revoke the therapeutic links. Its main purpose is to allow one to “end” the (declaration of a) therapeutic link.
GetTherapeuticLink	Used to consult therapeutic links according to basic search parameters. Its main purpose is to allow one to check the existence of the therapeutic links when executing a consultation process
HasTherapeuticLink	Used to check the existence of a therapeutic link

The therapeutic links are managed according to the rules corresponding to the type of therapeutic link through:

Specific webservices (WS) by HC professionals as end-users through their usual software or through an authorized organization
A dedicated web application (WA), currently called eHealth Consent with following end-users: Patients and HC professionals/ HC professionals within an organization

	Declare/Put	Revoke	Consult (Get)	Has
Citizen (patient, parent, mandatary)	Yes	Yes	Yes	Yes
Authorized HC Parties (HC professionals)	Yes	Yes	Yes	Yes
Authorized HC organizations	No	No	Yes	Yes

KMEHR

This service is a ‘KMEHR-based’ WS. We thus strongly recommend consulting the documentation related to the KMEHR normative elements. The KMEHR site aims to offer a central point for the documentation of the KMEHR normative elements.

https://www.ehealth.fgov.be/standards/kmehr/en

The three following generic elements are, in particular, essentials to build the request and the reply of the therapeutic link WS.

cd : This is the key element used to code information: this section is completely based on the description from the KMEHR standard, as can be found on: https://www.ehealth.fgov.be/standards/kmehr/en/page/key-elements#cd
id: This element is used to uniquely identify key elements like request, response of the WS, patient, HCParty. It can also be used to specify any unique identifier: this section is completely based on the description from the KMEHR standard, as can be found on: https://www.ehealth.fgov.be/standards/kmehr/en/page/key-elements#id
HC Party: The hcparty element is a generic element that aims to represent any kind of healthcare party: organization, physician, medical specialty, or even IT systems: this section is entirely based on the description from the KMEHR standard, as can be found on: https://www.ehealth.fgov.be/standards/kmehr/en/page/hcparty

Basic Flow

Flow

Specifications

ID	UC-239-BF
Name	Put Therapeutic Link - HC Professional - Consultation - eID reading
Description	Put Therapeutic Link, service used to declare a therapeutic link between a patient and a HC party. HC Professional acts as author of the Put Therapeutic Link. The given proof is the e-ID card reading of the patient. Certificate used to access the WS Therapeutic Link is the eHealth Certificate of the end-user (HC Professional). All professionals of AR78 are allowed to manage the therapeutic link "Consultation" (Dentist, Midwife, Audician, Physiotherapist, Occupational therapist, Practical nurse, Dietician, Audiologist, Podologist, Truss maker, Logopedist, Orthoptist, Lab technologist, Imaging technologist, clinical orthopedic pedagogue)
Actor(s)	HC Professional of AR78 (Dentist, Midwife, Audician, Physiotherapist, Occupational therapist, Practical nurse, Dietician, Audiologist, Podologist, Truss maker, Logopedist, Orthoptist, Lab technologist, Imaging technologist, clinical orthopedic pedagogue)
Requirements	End-user is a HC professional of AR78 (Dentist, Midwife, Audician, Physiotherapist, Occupational therapist, Practical nurse, Dietician, Audiologist, Podologist, Truss maker, Logopedist, Orthoptist, Lab technologist, Imaging technologist, clinical orthopedic pedagogue) End-user manages the therapeutic links throughout his usual software Valid personal eHealth Certificate e-ID card of concerned patient Identification HC professional: SSIN, NIHII (if available), HC professional category Identification concerned patient: SSIN, e-ID card number, first and family name Identification concerned HC party: SSIN, NIHII (if available), HC party category, first and family name (optional) Type of therapeutic link °physician: gpconsultation or specialistconsultation °nurse: nurseconsultation °other professionals: consultation Period of validity: 15 months Start date (optional) End date (optional) Comment to justify the revocation (optional) Information about the evidence of the declaration: SSIN support card number Type of proof: e-ID reading
Trigger	The user wants to put a therapeutic link
Precondition(s)	The user has an account for the application The user is logged out
Flow	The user attempts to access the eHealth WS Therapeutic Link The user needs to request a SAML Token by using it's personal eHealth Certificate A request for a SAML Token is sent to the Secure Token Service (STS) The STS responds with a SAML Token The user has access to the eHealth WS Therapeutic Link The user does a request for Put Therapeutic Link The Put Therapeutic Link Request is sent to the WS Therapeutic Link The Therapeutic link is created in eHealth Database The request is logged The WS Consent responds with a Therapeutic Link Response
Post Condition(s)	Request is logged The Therapeutic Link is created in eHealth Database
Test Data	Put Therapeutic Link - HC Professional Example Put Therapeutic Link Request Example Put Therapeutic Link Response Example Put Therapeutic Link Response - Unsuccessful
End point(s)	Therapeutic Link Database
Remarks	The inclusive start date is optional: - If provided then the start date must be equal to the declaration date i.e. the date when the declaration request is processed (the current date) else the request is rejected. - If not provided then the start date is enriched with the date when the declaration request is processed i.e. the current date. The exclusive end date is optional and depending on the given evidence: o If provided then the end date must be equal to start date plus (+) the default period of validity else the end date is discarded and enriched w/ the ED = SD + the default period of validity. o If not provided then the end date is enriched w/ the ED = SD + the default period of validity. o For a non-referral relation, the default period of validity is defined as follows: ED = SD + 15 months
Additional Information	For the overlapped relations, the start date of the new period must be greater or equal to the start date of the period to extended and the end-date of the new period must be greater than the end-date of the period to be extended
Remarks end-users	Should be available soon for clinical orthopedic pedagogue, clinical psychologist & dental hygienist

Exception Flow 1