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Patient Administration Work GroupMaturity Level: 3 Trial UseSecurity Category: Patient Compartments: Device, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the Appointment resource.

Appointment
Element IdAppointment
Definition

A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s).

Cardinality0..*
TypeDomainResource
Invariants
Defined on this element
app-2Rule Either start and end are specified, or neitherstart.exists() = end.exists()
app-3Rule Only proposed or cancelled appointments can be missing start/end dates(start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4Rule Cancelation reason is only used for appointments that have been cancelled, or no-showAppointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
Appointment.identifier
Element IdAppointment.identifier
Definition

This records identifiers associated with this appointment concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Summarytrue
Appointment.status
Element IdAppointment.status
Definition

The overall status of the Appointment. Each of the participants has their own participation status which indicates their involvement in the process, however this status indicates the shared status.

Cardinality1..1
Terminology BindingAppointmentStatus (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
Comments

If the Appointment's status is "cancelled" then all participants are expected to have their calendars released for the appointment period, and as such any Slots that were marked as BUSY can be re-set to FREE.

This element is labeled as a modifier because the status contains the code entered-in-error that mark the Appointment as not currently valid.

Appointment.cancelationReason
Element IdAppointment.cancelationReason
Definition

The coded reason for the appointment being cancelled. This is often used in reporting/billing/futher processing to determine if further actions are required, or specific fees apply.

Cardinality0..1
Terminology BindingAppointment cancellation reason (Example)
TypeCodeableConcept
Summarytrue
Appointment.serviceCategory
Element IdAppointment.serviceCategory
Definition

A broad categorization of the service that is to be performed during this appointment.

Cardinality0..*
Terminology BindingService category (Example)
TypeCodeableConcept
Summarytrue
Appointment.serviceType
Element IdAppointment.serviceType
Definition

The specific service that is to be performed during this appointment.

Cardinality0..*
Terminology BindingService type (Example)
TypeCodeableConcept
Summarytrue
Comments

For a provider to provider appointment the code "FOLLOWUP" may be appropriate, as this is expected to be discussing some patient that was seen in the past.

Appointment.specialty
Element IdAppointment.specialty
Definition

The specialty of a practitioner that would be required to perform the service requested in this appointment.

Cardinality0..*
Terminology BindingPractice Setting Code Value Set (Preferred)
TypeCodeableConcept
Summarytrue
Appointment.appointmentType
Element IdAppointment.appointmentType
Definition

The style of appointment or patient that has been booked in the slot (not service type).

Cardinality0..1
Terminology Bindingv2 Appointment Reason Codes (Preferred)
TypeCodeableConcept
Summarytrue
Appointment.reasonCode
Element IdAppointment.reasonCode
Definition

The coded reason that this appointment is being scheduled. This is more clinical than administrative.

Cardinality0..*
Terminology BindingEncounter Reason Codes (Preferred)
TypeCodeableConcept
Summarytrue
Appointment.reasonReference
Element IdAppointment.reasonReference
Definition

Reason the appointment has been scheduled to take place, as specified using information from another resource. When the patient arrives and the encounter begins it may be used as the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

Cardinality0..*
TypeReference(Condition | Procedure | Observation | ImmunizationRecommendation)
Appointment.priority
Element IdAppointment.priority
Definition

The priority of the appointment. Can be used to make informed decisions if needing to re-prioritize appointments. (The iCal Standard specifies 0 as undefined, 1 as highest, 9 as lowest priority).

Cardinality0..1
TypeunsignedInt
Comments

Seeking implementer feedback on this property and how interoperable it is.

Using an extension to record a CodeableConcept for named values may be tested at a future connectathon.

Appointment.description
Element IdAppointment.description
Definition

The brief description of the appointment as would be shown on a subject line in a meeting request, or appointment list. Detailed or expanded information should be put in the comment field.

Cardinality0..1
Typestring
Appointment.supportingInformation
Element IdAppointment.supportingInformation
Definition

Additional information to support the appointment provided when making the appointment.

Cardinality0..*
TypeReference(Any)
Appointment.start
Element IdAppointment.start
Definition

Date/Time that the appointment is to take place.

Cardinality0..1
Typeinstant
Summarytrue
Appointment.end
Element IdAppointment.end
Definition

Date/Time that the appointment is to conclude.

Cardinality0..1
Typeinstant
Summarytrue
Appointment.minutesDuration
Element IdAppointment.minutesDuration
Definition

Number of minutes that the appointment is to take. This can be less than the duration between the start and end times. For example, where the actual time of appointment is only an estimate or if a 30 minute appointment is being requested, but any time would work. Also, if there is, for example, a planned 15 minute break in the middle of a long appointment, the duration may be 15 minutes less than the difference between the start and end.

Cardinality0..1
TypepositiveInt
Appointment.slot
Element IdAppointment.slot
Definition

The slots from the participants' schedules that will be filled by the appointment.

Cardinality0..*
TypeReference(Slot)
Appointment.created
Element IdAppointment.created
Definition

The date that this appointment was initially created. This could be different to the meta.lastModified value on the initial entry, as this could have been before the resource was created on the FHIR server, and should remain unchanged over the lifespan of the appointment.

Cardinality0..1
TypedateTime
Comments

This property is required for many use cases where the age of an appointment is considered in processing workflows for scheduling and billing of appointments.

Appointment.comment
Element IdAppointment.comment
Definition

Additional comments about the appointment.

Cardinality0..1
Typestring
Comments

Additional text to aid in facilitating the appointment. For instance, a comment might be, "patient should proceed immediately to infusion room upon arrival"

Where this is a planned appointment and the start/end dates are not set then this field can be used to provide additional guidance on the details of the appointment request, including any restrictions on when to book it.

Appointment.patientInstruction
Element IdAppointment.patientInstruction
Definition

While Appointment.comment contains information for internal use, Appointment.patientInstructions is used to capture patient facing information about the Appointment (e.g. please bring your referral or fast from 8pm night before).

Cardinality0..1
Typestring
Appointment.basedOn
Element IdAppointment.basedOn
Definition

The service request this appointment is allocated to assess (e.g. incoming referral or procedure request).

Cardinality0..*
TypeReference(ServiceRequest)
Alternate NamesincomingReferral
Appointment.participant
Element IdAppointment.participant
Definition

List of participants involved in the appointment.

Cardinality1..*
Invariants
Defined on this element
app-1Rule Either the type or actor on the participant SHALL be specifiedtype.exists() or actor.exists()
Appointment.participant.type
Element IdAppointment.participant.type
Definition

Role of participant in the appointment.

Cardinality0..*
Terminology BindingParticipant type (Extensible)
TypeCodeableConcept
Summarytrue
Comments

The role of the participant can be used to declare what the actor will be doing in the scope of this appointment.

If the actor is not specified, then it is expected that the actor will be filled in at a later stage of planning.

This value SHALL be the same when creating an AppointmentResponse so that they can be matched, and subsequently update the Appointment.

Appointment.participant.actor
Element IdAppointment.participant.actor
Definition

A Person, Location/HealthcareService or Device that is participating in the appointment.

Cardinality0..1
TypeReference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location)
Summarytrue
Appointment.participant.required
Element IdAppointment.participant.required
Definition

Whether this participant is required to be present at the meeting. This covers a use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.

Cardinality0..1
Terminology BindingParticipantRequired (Required)
Typecode
Summarytrue
Appointment.participant.status
Element IdAppointment.participant.status
Definition

Participation status of the actor.

Cardinality1..1
Terminology BindingParticipationStatus (Required)
Typecode
Summarytrue
Appointment.participant.period
Element IdAppointment.participant.period
Definition

Participation period of the actor.

Cardinality0..1
TypePeriod
Appointment.requestedPeriod
Element IdAppointment.requestedPeriod
Definition

A set of date ranges (potentially including times) that the appointment is preferred to be scheduled within.

The duration (usually in minutes) could also be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time. However, in other situations the duration may be calculated by the scheduling system.

Cardinality0..*
TypePeriod
Comments

This does not introduce a capacity for recurring appointments.