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Patient Administration icon 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).

Short DisplayA 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
Summaryfalse
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 Cancellation reason is only used for appointments that have been cancelled, or noshowcancellationReason.exists() implies (status='noshow' or status='cancelled')
app-5Rule The start must be less than or equal to the endstart.exists() implies start <= end
app-6Guideline An appointment may have an originatingAppointment or recurrenceTemplate, but not bothoriginatingAppointment.exists().not() or recurrenceTemplate.exists().not()
This is (only) a best practice guideline because:

For a recurring series of appointments, the originating appointment should have the recurrenceTemplate defining the details of the overall recurrence. Each occurence should refer back to the originatingAppointment as the single source of truth for the details of the recurrence.

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).

Short DisplayExternal Ids for this item
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.

Short Displayproposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
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.cancellationReason
Element IdAppointment.cancellationReason
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.

Short DisplayThe coded reason for the appointment being cancelled
Cardinality0..1
Terminology BindingAppointmentCancellationReason (Example)
TypeCodeableConcept
Summarytrue
Appointment.class
Element IdAppointment.class
Definition

Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

Short DisplayClassification when becoming an encounter
Cardinality0..*
Terminology BindingEncounterClass icon:
TypeCodeableConcept
Summarytrue
Appointment.serviceCategory
Element IdAppointment.serviceCategory
Definition

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

Short DisplayA broad categorization of the service that is to be performed during this appointment
Cardinality0..*
Terminology BindingServiceCategory (Example)
TypeCodeableConcept
Summarytrue
Appointment.serviceType
Element IdAppointment.serviceType
Definition

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

Short DisplayThe specific service that is to be performed during this appointment
Cardinality0..*
Terminology BindingServiceType (Example)
TypeCodeableReference(HealthcareService)
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.

Short DisplayThe 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).

Short DisplayThe style of appointment or patient that has been booked in the slot (not service type)
Cardinality0..1
Terminology Bindinghl7VS-appointmentReasonCodes icon (Preferred)
TypeCodeableConcept
Summarytrue
Appointment.reason
Element IdAppointment.reason
Definition

The reason that this appointment is being scheduled. This is more clinical than administrative. This can be coded, or 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.

Short DisplayReason this appointment is scheduled
Cardinality0..*
Terminology BindingEncounter Reason Codes (Preferred)
TypeCodeableReference(Condition | Procedure | Observation | ImmunizationRecommendation)
Summarytrue
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).

Short DisplayUsed to make informed decisions if needing to re-prioritize
Cardinality0..1
Terminology BindingActPriority icon (Example)
TypeCodeableConcept
Summaryfalse
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.

Short DisplayShown on a subject line in a meeting request, or appointment list
Cardinality0..1
Typestring
Summaryfalse
Appointment.replaces
Element IdAppointment.replaces
Definition

Appointment replaced by this Appointment in cases where there is a cancellation, the details of the cancellation can be found in the cancellationReason property (on the referenced resource).

Short DisplayAppointment replaced by this Appointment
Cardinality0..*
TypeReference(Appointment)
Summaryfalse
Appointment.virtualService
Element IdAppointment.virtualService
Definition

Connection details of a virtual service (e.g. conference call).

Short DisplayConnection details of a virtual service (e.g. conference call)
Cardinality0..*
TypeVirtualServiceDetail
Summaryfalse
Comments

There are two types of virtual meetings that often exist:

  • a persistent, virtual meeting room that can only be used for a single purpose at a time,
  • and a dynamic virtual meeting room that is generated on demand for a specific purpose.

Implementers may consider using Location.virtualService for persistent meeting rooms.

If each participant would have a different meeting link, an extension using the VirtualServiceContactDetail can be applied to the Appointment.participant BackboneElement.

Appointment.supportingInformation
Element IdAppointment.supportingInformation
Definition

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

Short DisplayAdditional information to support the appointment
Cardinality0..*
TypeReference(Any)
Summaryfalse
Appointment.previousAppointment
Element IdAppointment.previousAppointment
Definition

The previous appointment in a series of related appointments.

Short DisplayThe previous appointment in a series
Cardinality0..1
TypeReference(Appointment)
Summaryfalse
Comments

This property is intended for use when representing a series of related appointments. For example, in a nuclear medicine procedure, where there is an appointment for the injection of the isotopes, and then a subsequent appointment for the scan, the scan appointment would refer to the injection appointment via Appointment.previousAppointment. For representing recurring appointments, see the guidance on recurring vs. series appointments.

Appointment.originatingAppointment
Element IdAppointment.originatingAppointment
Definition

The originating appointment in a recurring set of related appointments.

Short DisplayThe originating appointment in a recurring set of appointments
Cardinality0..1
TypeReference(Appointment)
Summaryfalse
Comments

This property is intended for use when representing a recurring set of related appointments.

For example, a patient undergoing physical therapy may have a recurring appointment every Tuesday and Thursday. Each occurrence of the set will refer to the originating appointment, which contains the recurring template information. For representing appointment series, see the guidance on recurring vs. series appointments.

Appointment.start
Element IdAppointment.start
Definition

Date/Time that the appointment is to take place.

Short DisplayWhen appointment is to take place
Cardinality0..1
Typeinstant
Summarytrue
Appointment.end
Element IdAppointment.end
Definition

Date/Time that the appointment is to conclude.

Short DisplayWhen 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.

Short DisplayCan be less than start/end (e.g. estimate)
Cardinality0..1
TypepositiveInt
Summaryfalse
Appointment.slot
Element IdAppointment.slot
Definition

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

Short DisplayThe slots that this appointment is filling
Cardinality0..*
TypeReference(Slot)
Summaryfalse
Appointment.account
Element IdAppointment.account
Definition

The set of accounts that is expected to be used for billing the activities that result from this Appointment.

Short DisplayThe set of accounts that may be used for billing for this Appointment
Cardinality0..*
TypeReference(Account)
Summaryfalse
Comments

The specified account(s) could be those identified during pre-registration workflows in preparation for an upcoming Encounter.

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.

Short DisplayThe date that this appointment was initially created
Cardinality0..1
TypedateTime
Summaryfalse
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.note
Element IdAppointment.note
Definition

Additional notes/comments about the appointment.

Short DisplayAdditional comments
Cardinality0..*
TypeAnnotation
Summaryfalse
Comments

Additional text to aid in facilitating the appointment. For instance, a note 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.

Typically only the concept.text will be used, however occasionally a reference to some generic documentation (or specific) and also supports coded instructions if/when they are required.

Appointment.patientInstruction
Element IdAppointment.patientInstruction
Definition

While Appointment.note 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).

Short DisplayDetailed information and instructions for the patient
Cardinality0..*
TypeCodeableReference(DocumentReference | Binary | Communication)
Summaryfalse
Appointment.basedOn
Element IdAppointment.basedOn
Definition

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

Short DisplayThe request this appointment is allocated to assess
Cardinality0..*
TypeReference(CarePlan | DeviceRequest | MedicationRequest | ServiceRequest)
Alternate NamesincomingReferral
Summaryfalse
Appointment.subject
Element IdAppointment.subject
Definition

The patient or group associated with the appointment, if they are to be present (usually) then they should also be included in the participant backbone element.

Short DisplayThe patient or group associated with the appointment
Cardinality0..1
TypeReference(Patient | Group)
Summarytrue
Appointment.participant
Element IdAppointment.participant
Definition

List of participants involved in the appointment.

Short DisplayParticipants involved in appointment
Cardinality1..*
Summaryfalse
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.

Short DisplayRole of participant in the appointment
Cardinality0..*
Terminology BindingParticipantType (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.period
Element IdAppointment.participant.period
Definition

Participation period of the actor.

Short DisplayParticipation period of the actor
Cardinality0..1
TypePeriod
Summaryfalse
Appointment.participant.actor
Element IdAppointment.participant.actor
Definition

The individual, device, location, or service participating in the appointment.

Short DisplayThe individual, device, location, or service participating in the appointment
Cardinality0..1
TypeReference(Patient | Group | Practitioner | PractitionerRole | CareTeam | RelatedPerson | Device | HealthcareService | Location)
Summarytrue
Comments

Where a CareTeam is provided, this does not imply that the entire team is included, just a single member from the group with the appropriate role. Where multiple members are required, please include the CareTeam the required number of times.

Appointment.participant.required
Element IdAppointment.participant.required
Definition

Whether this participant is required to be present at the meeting. If false, the participant is optional.

Short DisplayThe participant is required to attend (optional when false)
Cardinality0..1
Typeboolean
Summarytrue
Comments

For the 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 include the patient in the subject field, but do not include them as a participant - this was formerly done prior to R5 with required='information-only'.

Appointment.participant.status
Element IdAppointment.participant.status
Definition

Participation status of the actor.

Short Displayaccepted | declined | tentative | needs-action
Cardinality1..1
Terminology BindingParticipationStatus (Required)
Typecode
Summarytrue
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.

Short DisplayPotential date/time interval(s) requested to allocate the appointment within
Cardinality0..*
TypePeriod
Summaryfalse
Comments

This does not introduce a capacity for recurring appointments.

Appointment.recurrenceId
Element IdAppointment.recurrenceId
Definition

The sequence number that identifies a specific appointment in a recurring pattern.

Short DisplayThe sequence number in the recurrence
Cardinality0..1
TypepositiveInt
Summaryfalse
Appointment.occurrenceChanged
Element IdAppointment.occurrenceChanged
Definition

This appointment varies from the recurring pattern.

Short DisplayIndicates that this appointment varies from a recurrence pattern
Cardinality0..1
Typeboolean
Summaryfalse
Comments

For example, if a patient has physical therapy appointments every Tuesday and Thursday, but due to a national holiday, an single occurrence was rescheduled to a different day, while the rest of the recurring series remained on Tuesday / Thursday.

Appointment.recurrenceTemplate
Element IdAppointment.recurrenceTemplate
Definition

The details of the recurrence pattern or template that is used to generate recurring appointments.

Short DisplayDetails of the recurrence pattern/template used to generate occurrences
Cardinality0..*
Summaryfalse
Appointment.recurrenceTemplate.timezone
Element IdAppointment.recurrenceTemplate.timezone
Definition

The timezone of the recurring appointment occurrences.

Short DisplayThe timezone of the occurrences
Cardinality0..1
Terminology BindingIANA Timezones (Required)
TypeCodeableConcept
Summaryfalse
Appointment.recurrenceTemplate.recurrenceType
Element IdAppointment.recurrenceTemplate.recurrenceType
Definition

How often the appointment series should recur.

Short DisplayThe frequency of the recurrence
Cardinality1..1
Terminology BindingAppointmentRecurrenceType (Preferred)
TypeCodeableConcept
Summaryfalse
Appointment.recurrenceTemplate.lastOccurrenceDate
Element IdAppointment.recurrenceTemplate.lastOccurrenceDate
Definition

Recurring appointments will not occur after this date.

Short DisplayThe date when the recurrence should end
Cardinality0..1
Typedate
Summaryfalse
Appointment.recurrenceTemplate.occurrenceCount
Element IdAppointment.recurrenceTemplate.occurrenceCount
Definition

How many appointments are planned in the recurrence.

Short DisplayThe number of planned occurrences
Cardinality0..1
TypepositiveInt
Summaryfalse
Appointment.recurrenceTemplate.occurrenceDate
Element IdAppointment.recurrenceTemplate.occurrenceDate
Definition

The list of specific dates that will have appointments generated.

Short DisplaySpecific dates for a recurring set of appointments (no template)
Cardinality0..*
Typedate
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate
Element IdAppointment.recurrenceTemplate.weeklyTemplate
Definition

Information about weekly recurring appointments.

Short DisplayInformation about weekly recurring appointments
Cardinality0..1
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate.monday
Element IdAppointment.recurrenceTemplate.weeklyTemplate.monday
Definition

Indicates that recurring appointments should occur on Mondays.

Short DisplayRecurs on Mondays
Cardinality0..1
Typeboolean
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate.tuesday
Element IdAppointment.recurrenceTemplate.weeklyTemplate.tuesday
Definition

Indicates that recurring appointments should occur on Tuesdays.

Short DisplayRecurs on Tuesday
Cardinality0..1
Typeboolean
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate.wednesday
Element IdAppointment.recurrenceTemplate.weeklyTemplate.wednesday
Definition

Indicates that recurring appointments should occur on Wednesdays.

Short DisplayRecurs on Wednesday
Cardinality0..1
Typeboolean
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate.thursday
Element IdAppointment.recurrenceTemplate.weeklyTemplate.thursday
Definition

Indicates that recurring appointments should occur on Thursdays.

Short DisplayRecurs on Thursday
Cardinality0..1
Typeboolean
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate.friday
Element IdAppointment.recurrenceTemplate.weeklyTemplate.friday
Definition

Indicates that recurring appointments should occur on Fridays.

Short DisplayRecurs on Friday
Cardinality0..1
Typeboolean
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate.saturday
Element IdAppointment.recurrenceTemplate.weeklyTemplate.saturday
Definition

Indicates that recurring appointments should occur on Saturdays.

Short DisplayRecurs on Saturday
Cardinality0..1
Typeboolean
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate.sunday
Element IdAppointment.recurrenceTemplate.weeklyTemplate.sunday
Definition

Indicates that recurring appointments should occur on Sundays.

Short DisplayRecurs on Sunday
Cardinality0..1
Typeboolean
Summaryfalse
Appointment.recurrenceTemplate.weeklyTemplate.weekInterval
Element IdAppointment.recurrenceTemplate.weeklyTemplate.weekInterval
Definition

The interval defines if the recurrence is every nth week. The default is every week, so it is expected that this value will be 2 or more.

e.g. For recurring every second week this interval would be 2, or every third week the interval would be 3.

Short DisplayRecurs every nth week
Cardinality0..1
TypepositiveInt
Summaryfalse
Appointment.recurrenceTemplate.monthlyTemplate
Element IdAppointment.recurrenceTemplate.monthlyTemplate
Definition

Information about monthly recurring appointments.

Short DisplayInformation about monthly recurring appointments
Cardinality0..1
Summaryfalse
Appointment.recurrenceTemplate.monthlyTemplate.dayOfMonth
Element IdAppointment.recurrenceTemplate.monthlyTemplate.dayOfMonth
Definition

Indicates that appointments in the series of recurring appointments should occur on a specific day of the month.

Short DisplayRecurs on a specific day of the month
Cardinality0..1
TypepositiveInt
Summaryfalse
Appointment.recurrenceTemplate.monthlyTemplate.nthWeekOfMonth
Element IdAppointment.recurrenceTemplate.monthlyTemplate.nthWeekOfMonth
Definition

Indicates which week within a month the appointments in the series of recurring appointments should occur on.

Short DisplayIndicates which week of the month the appointment should occur
Cardinality0..1
Terminology BindingWeekOfMonth (Required)
TypeCoding
Summaryfalse
Appointment.recurrenceTemplate.monthlyTemplate.dayOfWeek
Element IdAppointment.recurrenceTemplate.monthlyTemplate.dayOfWeek
Definition

Indicates which day of the week the recurring appointments should occur each nth week.

Short DisplayIndicates which day of the week the appointment should occur
Cardinality0..1
Terminology BindingDaysOfWeek (Required)
TypeCoding
Summaryfalse
Comments

This property is intended to be used with Appointment.recurrenceTemplate.monthly.nthWeek.

Appointment.recurrenceTemplate.monthlyTemplate.monthInterval
Element IdAppointment.recurrenceTemplate.monthlyTemplate.monthInterval
Definition

Indicates that recurring appointments should occur every nth month.

Short DisplayRecurs every nth month
Cardinality1..1
TypepositiveInt
Summaryfalse
Appointment.recurrenceTemplate.yearlyTemplate
Element IdAppointment.recurrenceTemplate.yearlyTemplate
Definition

Information about yearly recurring appointments.

Short DisplayInformation about yearly recurring appointments
Cardinality0..1
Summaryfalse
Appointment.recurrenceTemplate.yearlyTemplate.yearInterval
Element IdAppointment.recurrenceTemplate.yearlyTemplate.yearInterval
Definition

Appointment recurs every nth year.

Short DisplayRecurs every nth year
Cardinality1..1
TypepositiveInt
Summaryfalse
Appointment.recurrenceTemplate.excludingDate
Element IdAppointment.recurrenceTemplate.excludingDate
Definition

Any dates, such as holidays, that should be excluded from the recurrence.

Short DisplayAny dates that should be excluded from the series
Cardinality0..*
Typedate
Summaryfalse
Comments

excludingDate is an alternative to excludingRecurrenceId. You may say either that 12/25/XXXX should be excluded using excludingDate, or you may indicate the recurrenceId of the appointment that would fall on the excluded date in the excludingRecurrenceId property.

Appointment.recurrenceTemplate.excludingRecurrenceId
Element IdAppointment.recurrenceTemplate.excludingRecurrenceId
Definition

Any dates, such as holidays, that should be excluded from the recurrence.

Short DisplayAny recurrence IDs that should be excluded from the recurrence
Cardinality0..*
TypepositiveInt
Summaryfalse
Comments

excludingRecurrenceId is an alternative to excludingDate. You may say either that 12/25/XXXX should be excluded using excludingDate, or you may indicate the recurrenceId of the appointment that would fall on the excluded date in the excludingRecurrenceId property.