Release 5 Draft Ballot

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions

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
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 no-showcancellationReason.exists() implies (status='no-show' or status='cancelled')
app-5Rule The start must be less than or equal to the endstart.exists() implies start <= end
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.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.

Cardinality0..1
Terminology BindingAppointmentCancellationReason (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 BindingServiceCategory (Example)
TypeCodeableConcept
Summarytrue
Appointment.serviceType
Element IdAppointment.serviceType
Definition

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

Cardinality0..*
Terminology BindingServiceType (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 Bindingspecialty :
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 Bindinghl7VS-appointmentReasonCodes (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.

Cardinality0..*
Terminology BindingEncounter Reason Codes (Preferred)
TypeCodeableReference(Condition | Procedure | Observation | ImmunizationRecommendation)
PatternsCodeableReference(Condition,Procedure,Observation,ImmunizationRecommendation): No common pattern
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).

Cardinality0..1
Terminology BindingActPriority (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.

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).

Cardinality0..*
TypeReference(Appointment)
Summaryfalse
Appointment.supportingInformation
Element IdAppointment.supportingInformation
Definition

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

Cardinality0..*
TypeReference(Any)
Summaryfalse
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
Summaryfalse
Appointment.slot
Element IdAppointment.slot
Definition

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

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.

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.

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.

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).

Cardinality0..*
TypeCodeableReference(DocumentReference | Binary | Communication)
PatternsCodeableReference(DocumentReference,Binary,Communication): No common pattern
Summaryfalse
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
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.

Cardinality0..1
TypeReference(Patient | Group)
PatternsReference(Patient,Group): Common patterns = Participant
Summarytrue
Appointment.participant
Element IdAppointment.participant
Definition

List of participants involved in the 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.

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.

Cardinality0..1
TypePeriod
Summaryfalse
Appointment.participant.actor
Element IdAppointment.participant.actor
Definition

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

Cardinality0..1
TypeReference(Patient | Group | Practitioner | PractitionerRole | CareTeam | RelatedPerson | Device | HealthcareService | Location)
PatternsReference(Patient,Group,Practitioner,PractitionerRole,CareTeam,RelatedPerson,Device,HealthcareService,Location): Common patterns = Participant
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.

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.

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.

Cardinality0..*
TypePeriod
Summaryfalse
Comments

This does not introduce a capacity for recurring appointments.