Scheduling
1.0.1-current - ci-build International flag

Scheduling, published by IHE IT Infrastructure Technical Committee. This guide is not an authorized publication; it is the continuous build for version 1.0.1-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/ITI.Scheduling/ and changes regularly. See the Directory of published versions

Resource Profile: IHE_ITI_Appointment_Profile - Detailed Descriptions

Active as of 2023-01-13

Definitions for the ihe-sched-appt resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Appointment
Must Supportfalse
2. Appointment.extension:status-reason-extension
Slice Namestatus-reason-extension
Control0..1
TypeExtension(Reason For Current Status) (Extension Type: CodeableConcept)
Must Supporttrue
4. Appointment.identifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Must Supporttrue
6. Appointment.status
Must Supporttrue
8. Appointment.serviceType
Control0..*
BindingUnless not suitable, these codes SHALL be taken from IHE ITI Scheduling Snomed CT Services
(extensible to https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services)
Must Supporttrue
10. Appointment.specialty
Control0..*
BindingUnless not suitable, these codes SHALL be taken from IHE ITI Scheduling Specialties
(extensible to https://profiles.ihe.net/ITI/Scheduling/ValueSet/specialty)
Must Supporttrue
12. Appointment.start
Control1..1
Must Supporttrue
14. Appointment.end
Control1..1
Must Supporttrue
16. Appointment.participant
18. Appointment.participant.actor
Control1..1
TypeReference(Location, Patient, Practitioner, PractitionerRole, HealthcareService)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
20. Appointment.participant.status
Must Supporttrue
22. Appointment.requestedPeriod
Control1..1
Must Supporttrue

Guidance on how to interpret the contents of this table can be found here

0. Appointment
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).

ShortA 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)
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsapp-2: Either start and end are specified, or neither (start.exists() = end.exists())
app-3: Only proposed or cancelled appointments can be missing start/end dates ((start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist')))
app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show (Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled'))
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
app-2: Either start and end are specified, or neither (start.exists() = end.exists())
app-3: Only proposed or cancelled appointments can be missing start/end dates ((start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist')))
app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show (Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled'))
2. Appointment.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Appointment.extension:status-reason-extension
Slice Namestatus-reason-extension
Definition

Captures the reason for the current state of the Appointment.

ShortReason For Current Status
Comments

This is generally only used for "exception" statuses such as not-done, suspended or cancelled. The reason for performing the event at all is captured in the reason element, not here.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Reason For Current Status) (Extension Type: CodeableConcept)
Is Modifierfalse
Must Supporttrue
Alternate NamesSuspended Reason, Cancelled Reason
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Appointment.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Appointment.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).

ShortExternal Ids for this item
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Appointment.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.

Shortproposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
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.

Control1..1
BindingThe codes SHALL be taken from AppointmentStatushttp://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1
(required to http://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1)

The free/busy status of an appointment.

Typecode
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Appointment.serviceType
Definition

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

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

Control0..*
BindingUnless not suitable, these codes SHALL be taken from For example codes, see IHE ITI Scheduling Snomed CT Serviceshttp://hl7.org/fhir/ValueSet/service-type
(extensible to https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. Appointment.specialty
Definition

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

ShortThe specialty of a practitioner that would be required to perform the service requested in this appointment
Control0..*
BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from IHE ITI Scheduling Specialtieshttp://hl7.org/fhir/ValueSet/c80-practice-codes
(extensible to https://profiles.ihe.net/ITI/Scheduling/ValueSet/specialty)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Appointment.start
Definition

Date/Time that the appointment is to take place.

ShortWhen appointment is to take place
Control10..1
Typeinstant
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Appointment.end
Definition

Date/Time that the appointment is to conclude.

ShortWhen appointment is to conclude
Control10..1
Typeinstant
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Appointment.participant
Definition

List of participants involved in the appointment.

ShortParticipants involved in appointment
Control1..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsapp-1: Either the type or actor on the participant SHALL be specified (type.exists() or actor.exists())
ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
app-1: Either the type or actor on the participant SHALL be specified (type.exists() or actor.exists())
22. Appointment.participant.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. Appointment.participant.actor
Definition

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

ShortPerson, Location/HealthcareService or Device
Control10..1
TypeReference(Location, Patient, Practitioner, PractitionerRole, HealthcareService, RelatedPerson, Device)
Is Modifierfalse
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Appointment.participant.status
Definition

Participation status of the actor.

Shortaccepted | declined | tentative | needs-action
Control1..1
BindingThe codes SHALL be taken from ParticipationStatushttp://hl7.org/fhir/ValueSet/participationstatus|4.0.1
(required to http://hl7.org/fhir/ValueSet/participationstatus|4.0.1)

The Participation status of an appointment.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Appointment.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.

ShortPotential date/time interval(s) requested to allocate the appointment within
Comments

This does not introduce a capacity for recurring appointments.

Control10..1*
TypePeriod
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. Appointment
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).

ShortA 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)
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsapp-2: Either start and end are specified, or neither (start.exists() = end.exists())
app-3: Only proposed or cancelled appointments can be missing start/end dates ((start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist')))
app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show (Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled'))
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Appointment.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. Appointment.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Appointment.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Appointment.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. Appointment.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Appointment.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. Appointment.extension
Definition

An Extension

ShortExtension
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Appointment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 16. Appointment.extension:status-reason-extension
    Slice Namestatus-reason-extension
    Definition

    Captures the reason for the current state of the Appointment.

    ShortReason For Current Status
    Comments

    This is generally only used for "exception" statuses such as not-done, suspended or cancelled. The reason for performing the event at all is captured in the reason element, not here.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Reason For Current Status) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Alternate NamesSuspended Reason, Cancelled Reason
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Appointment.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. Appointment.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).

    ShortExternal Ids for this item
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Appointment.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.

    Shortproposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
    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.

    Control1..1
    BindingThe codes SHALL be taken from AppointmentStatus
    (required to http://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1)

    The free/busy status of an appointment.

    Typecode
    Is Modifiertrue because 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
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Appointment.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.

    ShortThe coded reason for the appointment being cancelled
    Control0..1
    BindingFor example codes, see AppointmentCancellationReason
    (example to http://hl7.org/fhir/ValueSet/appointment-cancellation-reason)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Appointment.serviceCategory
    Definition

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

    ShortA broad categorization of the service that is to be performed during this appointment
    Control0..*
    BindingFor example codes, see ServiceCategory
    (example to http://hl7.org/fhir/ValueSet/service-category)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Appointment.serviceType
    Definition

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

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

    Control0..*
    BindingUnless not suitable, these codes SHALL be taken from IHE ITI Scheduling Snomed CT Services
    (extensible to https://profiles.ihe.net/ITI/Scheduling/ValueSet/sct-services)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Appointment.specialty
    Definition

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

    ShortThe specialty of a practitioner that would be required to perform the service requested in this appointment
    Control0..*
    BindingUnless not suitable, these codes SHALL be taken from IHE ITI Scheduling Specialties
    (extensible to https://profiles.ihe.net/ITI/Scheduling/ValueSet/specialty)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Appointment.appointmentType
    Definition

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

    ShortThe style of appointment or patient that has been booked in the slot (not service type)
    Control0..1
    BindingThe codes SHOULD be taken from hl7VS-appointmentReasonCodes
    (preferred to http://terminology.hl7.org/ValueSet/v2-0276)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Appointment.reasonCode
    Definition

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

    ShortCoded reason this appointment is scheduled
    Control0..*
    BindingThe codes SHOULD be taken from EncounterReasonCodes
    (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

    The Reason for the appointment to take place.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Appointment.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.

    ShortReason the appointment is to take place (resource)
    Control0..*
    TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. Appointment.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).

    ShortUsed to make informed decisions if needing to re-prioritize
    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.

    Control0..1
    TypeunsignedInt
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. Appointment.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.

    ShortShown on a subject line in a meeting request, or appointment list
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. Appointment.supportingInformation
    Definition

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

    ShortAdditional information to support the appointment
    Control0..*
    TypeReference(Resource)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. Appointment.start
    Definition

    Date/Time that the appointment is to take place.

    ShortWhen appointment is to take place
    Control1..1
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. Appointment.end
    Definition

    Date/Time that the appointment is to conclude.

    ShortWhen appointment is to conclude
    Control1..1
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    48. Appointment.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.

    ShortCan be less than start/end (e.g. estimate)
    Control0..1
    TypepositiveInt
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. Appointment.slot
    Definition

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

    ShortThe slots that this appointment is filling
    Control0..*
    TypeReference(Slot)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. Appointment.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.

    ShortThe date that this appointment was initially created
    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.

    Control0..1
    TypedateTime
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. Appointment.comment
    Definition

    Additional comments about the appointment.

    ShortAdditional comments
    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.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. Appointment.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).

    ShortDetailed information and instructions for the patient
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. Appointment.basedOn
    Definition

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

    ShortThe service request this appointment is allocated to assess
    Control0..*
    TypeReference(ServiceRequest)
    Is Modifierfalse
    Summaryfalse
    Alternate NamesincomingReferral
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    60. Appointment.participant
    Definition

    List of participants involved in the appointment.

    ShortParticipants involved in appointment
    Control1..*
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsapp-1: Either the type or actor on the participant SHALL be specified (type.exists() or actor.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. Appointment.participant.id
    Definition

    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

    ShortUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    64. Appointment.participant.extension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    66. Appointment.participant.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    68. Appointment.participant.type
    Definition

    Role of participant in the appointment.

    ShortRole of participant in the appointment
    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.

    Control0..*
    BindingUnless not suitable, these codes SHALL be taken from ParticipantType
    (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

    Role of participant in encounter.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. Appointment.participant.actor
    Definition

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

    ShortPerson, Location/HealthcareService or Device
    Control1..1
    TypeReference(Location, Patient, Practitioner, PractitionerRole, HealthcareService)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    72. Appointment.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.

    Shortrequired | optional | information-only
    Control0..1
    BindingThe codes SHALL be taken from ParticipantRequired
    (required to http://hl7.org/fhir/ValueSet/participantrequired|4.0.1)

    Is the Participant required to attend the appointment.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    74. Appointment.participant.status
    Definition

    Participation status of the actor.

    Shortaccepted | declined | tentative | needs-action
    Control1..1
    BindingThe codes SHALL be taken from ParticipationStatus
    (required to http://hl7.org/fhir/ValueSet/participationstatus|4.0.1)

    The Participation status of an appointment.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    76. Appointment.participant.period
    Definition

    Participation period of the actor.

    ShortParticipation period of the actor
    Control0..1
    TypePeriod
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    78. Appointment.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.

    ShortPotential date/time interval(s) requested to allocate the appointment within
    Comments

    This does not introduce a capacity for recurring appointments.

    Control1..1
    TypePeriod
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))