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A patient’s file is shared with a healthcare provider when a therapeutic relationship is established between the patient and this healthcare provider. A therapeutic relationship is a relationship between a patient and a healthcare provider in the context of which healthcare is provided, or simply put, the relationship of trust between patient and healthcare provider.

In the absence of a known therapeutic relationship in the system, healthcare providers do not, in principle, have access to the patient’s medical records. However, several other scenarios are possible where access to the file is required. Some examples to illustrate this:

• When a healthcare provider sends a sample to the hospital laboratory, a clinical biologist or laboratory technician can consult the patient’s file;
• Within the framework of clinical studies, medical data from health records may be consulted by a researcher;
• A healthcare provider is called by the patient’s general practitioner with questions about a report of a treatment some months ago;
• When a patient arrives unconscious in an emergency room and their representative cannot be reached in time, the healthcare provider will be able to consult the patient’s record in order to administer appropriate care.
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In the above cases, the healthcare provider must apply the ‘break the glass principle ‘. This will also be logged in the system with the corresponding justification of the care provider (e.g. the therapeutic relationship is not yet known by the system).

A patient can choose to deny specific healthcare providers access to their file (so-called “exclusion” of a healthcare provider). As a result, a healthcare provider may, in principle, no longer access the patient file in any way whatsoever. The patient may request an exclusion regardless of whether or not a therapeutic relationship exists or has existed. This allows a patient to apply for a preventive exclusion (e.g. if an ex-partner is a healthcare provider).

In order to ensure continuity of care, a temporary override of an exclusion may be applied. Suppose that an excluded healthcare provider is the only one on duty for a specific medical discipline for which the patient requires urgent care, this healthcare provider will still be able to gain access to the health record.

There are two different types of exclusions:

1. eHealth exclusions: via the eHealth platform, healthcare providers (with a NIHDI number) can be excluded. These are included in the nexuzhealth applications (starting at Q1 2023), but can only be managed via the eHealth platform (e.g. to stop an exclusion) which can be reached via https://www.mijngezondheid.belgie.be/.
2. nexuzhealth exclusions: via the nexuzhealth healthcare institutions healthcare providers and staff can also be excluded. These can be accessed and managed via mynexuzhealth, but are not taken over by the eHealth platform.

In order for an exclusion to have the broadest possible effect, it is therefore advisable to register it via the eHealth platform, where non-nexus healthcare institutions can also consult these exclusions (starting at Q1 2023).

For more information, click on Exclusion.

Via the nexuzhealth care institutions, care providers as well as support staff can be excluded. For example, an administrative employee who can no longer consult the patient’s agenda due to an exclusion.Via the eHealth platform, only healthcare providers with a NIHDI number can be excluded for the time being

For more information, click on: Exclusions.

An exclusion cannot be registered directly by the patient via mynexuzhealth. In order to register an exclusion, the patient must contact the hospital where the relevant healthcare provider or staff member is active. An application form will have to be completed.

If a healthcare provider or staff member works at several nexuzhealth healthcare institutions , the exclusion registered by one of these healthcare institutions will take effect in all nexuzhealth healthcare institutions. The patient can find the correct contact details via ‘Your healthcare facility’ in the mynexuzhealth (web) application or via the website of the hospital in question.

For more information click on: Exclusions.

The federal eHealth platform is used as a so-called metahub and connects all regional hubs (such as CoZo or VZN KUL) so that healthcare providers who have a therapeutic relationship with this patient can consult the available documents about the patient (provided the patient has given their global consent). The patient can register exclusions in the eHealth platform that will result in the excluded healthcare providers no longer having access to the health record via the eHealth platform.

Nexuzhealth supplies an Electronic Health Record (EHR) to the nexuzhealth care institutions. The exclusions of healthcare providers and staff members that the patient has registered via a nexuzhealth healthcare institution has effect in all nexuzhealth healthcare institutions.

In addition, the nexuzhealth applications take over the exclusions registered in the eHealth platform (starting at Q1 2023), so that the healthcare providers who were already excluded for the health record in the eHealth platform are automatically excluded for the health record in the nexuzhealth healthcare institutions.
Conversely, the eHealth platform does not take over any exclusions from the nexuzhealth applications.If the patient wants to stop an exclusion, this requires going through the same process as for the application. In concrete terms, this means that an exclusion originally registered via the eHealth platform must be stopped via the eHealth platform. An exclusion requested via a nexuzhealth healthcare institution can be stopped via the mynexuzhealth (web) application or via the nexuzhealth healthcare institution.

For more information, click on: Exclusions