Used Documentation

Cookbook	Version	Location
Therapeutic Exclusion Cookbook	1.2	https://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

PutTherapeuticExlusion	Allows the end-user to declare a therapeutic exclusion
RevokeTherapeuticExlusion	Allows the end-user to revoke of an active therapeutic exclusion
GetTherapeuticExlusion	Allows the end-user to consult the active therapeutic exclusion(s)

Basic Flow

Flow

Specifications

Id	UC-316-BF
Name	Put Therapeutic Exclusion - Patient - pharmacy
Description	Put Therapeutic Exclusion allows an end-user to declare a therapeutic exclusion. The excluded HC party is a pharmacy
Actor(s)	Patient
Requirements	End-user is a patient 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 not supported!, valid and compliant NIHII 8 digits, Organization category supported by the service, Organization name (optional)
Trigger	The user wants to Put a Therapeutic Exclusion
Preconditions	The user has an account for the application The user is logged out
Flow	The user attempts to access the eHealth Consent WS The user needs to request a SAML Token by using his eID 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 Exclusions The user does a request for Put Therapeutic Exclusion The Put Therapeutic Exclusion Request is sent to the WS Therapeutic Exclusions The Therapeutic Exclusion is stored in the eHealth Database The request is logged The WS Therapeutic Exclusions responds with a Put Therapeutic Exclusion Response
Post Conditions	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 °Author of the request °Audit data
Test Data	Example Put Therapeutic Exclusion Request Example Put Therapeutic Exclusion Response Successful Example Put Therapeutic Exclusion Response Unsuccessful
End point(s)	Therapeutic Exclusions Database
Remarks	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