Belgium's Medical Records Transition to BIHR: Transformation and Standardization from 2026

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Belgium is mandating a transition to the Belgian Integrated Health Record (BIHR) for all physicians, based on the eSant 2026-2029 action plan. This system is not a single central database but a virtual ensemble integrating sources like Recip-e and Vaccinnet. The core of this transformation involves adopting international standards: SNOMED CT will serve as the 'clinical language' defining diagnoses or procedures, while FHIR will standardize how data is structured and shared. This ensures that medications, lab results, and attestations maintain a uniform structure across all disciplines, enabling automatic information reuse. From 2026, the BIHR environment will deploy standardized record-keeping, automatic linking, and integrated care overviews. Software vendors must update their products, moving from single-discipline to interprofessional systems. For physicians, electronic records will change significantly, shifting away from free text toward structured 'care episodes' and 'sections.' Data protection is also enhanced, requiring pseudonymization and anonymization for secondary use under the European Health Data Space (EHDS). Access control becomes stricter, demanding explicit consent based on the therapeutic relationship. This national modernization effort in Belgium simultaneously prepares the country for mandatory European interoperability by 2029-2031.