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Used Documentation

CookbookVersionLocation
Therapeutic Exclusion
Cookbook
1.2https://www.ehealth.fgov.be/ehealthplatform/nl/search?q=therapeutic+exclusion

General Information

Therapeutic Exclusion

The existence of an active ‘therapeutic exclusion’ is a fundamental prerequisite for the citizen to prevent
healthcare providers from accessing his medical data. Therefore, the eHealth platform makes available to the
citizen a new web service (WS) called Therapeutic Exclusion.


Technically, we identify the following attributes for a therapeutic exclusion:

  • If the excluded healthcare party is a practitioner
    o The identification number of the Belgian National Register (INSS) of the patient
    o The INSS of the practitioner

          Therefore, if the practitioner has multiple healthcare professions i.e. multiple NIHII, multiple professional

          categories and being excluded for one profession, the practitioner is considered as excluded for other professions
          as well.

  • If the excluded healthcare party is an organization
    o The INSS of the patient;
    o The NIHII (Number assigned by the National Institute for Health and Invalidity Insurance) of the
    organization.

A citizen can exclude one or more healthcare parties and one or more citizens can exclude one healthcare party.

According to the current business rules, for the purpose of the therapeutic exclusion:

  • ‘Citizen’ means any patient; parent and mandatary of the concerned patient managing therapeutic
    exclusion through the Therapeutic Exclusion WS integrated in their usual software. 
  • Only following HC Parties can be excluded by citizen:
    o As practitioner: Physician, Nurse, Dentist, Midwife, Audician, Physiotherapist, Occupational
    therapist, Practical nurse, Dietician, Audiologist, Podologist, Truss maker, Logopedist, Orthoptist,
    Lab technologist, Imaging technologist.
    o As organization: Pharmacy


The management of the therapeutic exclusions consists of the following operations

PutTherapeuticExlusionAllows the end-user to declare a therapeutic exclusion
RevokeTherapeuticExlusionAllows the end-user to revoke of an active therapeutic exclusion
GetTherapeuticExlusionAllows the end-user to consult the active therapeutic exclusion(s)

Basic Flow

FlowSpecifications

IDUC-315-BF
NamePut Therapeutic Exclusion - Patient - Practitioner
DescriptionPut Therapeutic Exclusion allows an end-user to declare a therapeutic exclusion. The excluded HC party is a practitioner (HCP who can be excluded: KB78 except pharmacists)
Actor(s)Patient
Requirements
  • End-user is a patient
  • HCP who can be excluded: KB78 except pharmacists
  • Valid e-ID 
  • Identification end-user

     °Patient software information

     °Identification patient: SSIN

  • Identification concerned patient: SSIN, support card number (optional), first and family name
  • Identification excluded HC party: SSIN, NIHII, professional category, first and family name
TriggerThe user wants to Put a Therapeutic Exclusion 
Precondition(s)
  • The user has an account for the application
  • The user is logged out
Flow
  1. The user attempts to access the eHealth Consent WS
  2. The user needs to request a SAML Token by using his eID 
  3. A request for a SAML Token is sent to the Secure Token Service (STS)
  4. The STS responds with a SAML Token
  5. The user has access to the eHealth WS Therapeutic Exclusions
  6. The user does a request for Put Therapeutic Exclusion
  7. The Put Therapeutic Exclusion Request is sent to the WS Therapeutic Exclusions
  8. The Therapeutic Exclusion is stored in the eHealth Database
  9. The request is logged
  10. The WS Therapeutic Exclusions responds with a Put Therapeutic Exclusion Response 
Post Condition(s)
  • The request is logged
  • The Therapeutic Exclusion is stored in the eHealth Database with following information

       °INSS of the concerned patient

       °INSS & NIHII (if any) of the HC party

Test Data
End point(s)Therapeutic Exclusions Database
Additional Information
  • The support card numbers are optional: provided or not, it will not be submitted to card status validation
  • First and family name are optional, if not provided then they are enriched based on provided INSS
  • NIHII: if not provided then the NIHII is not enriched based on the provided INSS. If provided, the NIHII must be valid and compliant
Comments
  • The NISS identifies the patient.
  • The INSS identifies the excluded professional.
  • The NIHII identifies the excluded organization.
  • A cross validation is applied between INSS and the category professional of the excluded
      practitioner, if the provided INSS does not match the provided category professional
      then the declaration is rejected.
  • A cross validation is applied between the NIHII and the category professional of the
     excluded organization, if the provided NIHII does not match the provided category
     professional then the declaration is rejected.
  • There is no cross validation between provided NIHII and provided INSS, provided
     category professional of the excluded practitioner. The NIHII is considered as irrelevant
     information as the exclusion is applied on INSS patient and INSS excluded practitioner
  • It is not possible to ‘update’ an existing therapeutic exclusion. To achieve this aim, the
      active exclusion must first be revoked before declaring the new one.

Exception Flow

FlowSpecifications

IDUC-315-EF
NamePut Therapeutic Exclusion - Patient - Practitioner - Exclusion already exists in database for the concerned patient and excluded HC party
DescriptionPut Therapeutic Exclusion allows an end-user to declare a therapeutic exclusion. The excluded HC party is a practitioner (HCP who can be excluded: KB78 except pharmacists). Exclusion already exists in database for the concerned patient and excluded HC party
Actor(s)Patient
Requirements
  • End-user is a patient
  • HCP who can be excluded: KB78 except pharmacists
  • Valid e-ID 
  • Identification end-user

     °Patient software information

     °Identification patient: SSIN

  • Identification concerned patient: SSIN, support card number (optional), first and family name
  • Identification excluded HC party: SSIN, NIHII, professional category, first and family name
  • Exclusion already exists in database for the concerned patient and excluded HC party
TriggerThe user wants to Put a Therapeutic Exclusion 
Precondition(s)
  • The user has an account for the application
  • The user is logged out
Flow
  1. The user attempts to access the eHealth Consent WS
  2. The user needs to request a SAML Token by using his eID 
  3. A request for a SAML Token is sent to the Secure Token Service (STS)
  4. The STS responds with a SAML Token
  5. The user has access to the eHealth WS Therapeutic Exclusions
  6. The user does a request for Put Therapeutic Exclusion
  7. The Put Therapeutic Exclusion Request is sent to the WS Therapeutic Exclusions
  8. The WS Therapeutic Exclusions responds with a Put Therapeutic Exclusion Response: error message
Post Condition(s)Error message
Test Data
End point(s)Therapeutic Exclusions Database
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