RIVO-Noord Zorgviewer Implementation Guide
1.23.0 - CI build

RIVO-Noord Zorgviewer Implementation Guide, published by RIVO-NN HL7NL. This guide is not an authorized publication; it is the continuous build for version 1.23.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/RIVO-Noord/zorgviewer-ig/ and changes regularly. See the Directory of published versions

## Resource Profile: Appointment - Detailed Descriptions

Draft as of 2026-03-30

Definitions for the Appointment resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

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).
Short | 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)
Control | 0..*
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (`contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (`contained.where(('#'+id in %resource.descendants().reference).not()).empty()`) app-3: Only proposed or cancelled appointments can be missing start/end dates (`(start.exists() and end.exists()) or (status in ('proposed' | 'cancelled'))`) app-2: Either start and end are specified, or neither (`start.empty() xor end.exists()`) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty()) app-3: Only proposed or cancelled appointments can be missing start/end dates ((start.exists() and end.exists()) or (status in ('proposed' | 'cancelled'))) app-2: Either start and end are specified, or neither (start.empty() xor end.exists())
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.
Short | A 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Control | 0..1
Type | uri
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
4. 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. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Alternate Names | extensions, user content
6. 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.
Short | proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error
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.
Control | 1..1
Binding | The codes SHALL be taken from AppointmentStatus http://hl7.org/fhir/ValueSet/appointmentstatus|3.0.2 (required to `http://hl7.org/fhir/ValueSet/appointmentstatus|3.0.2` ) The free/busy status of an appointment.
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
8. Appointment.participant
Definition | List of participants involved in the appointment.
Short | Participants involved in appointment
Control | 1..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) app-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() | (children().count() > id.count())) app-1: Either the type or actor on the participant SHALL be specified (type.exists() or actor.exists())
10. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
12. Appointment.participant.status
Definition | Participation status of the actor.
Short | accepted | declined | tentative | needs-action
Control | 1..1
Binding | The codes SHALL be taken from ParticipationStatus http://hl7.org/fhir/ValueSet/participationstatus|3.0.2 (required to `http://hl7.org/fhir/ValueSet/participationstatus|3.0.2` ) The Participation status of an appointment.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension

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

0. Appointment

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

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).
Short | 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)
Control | 0..*
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (`contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (`contained.where(('#'+id in %resource.descendants().reference).not()).empty()`) app-3: Only proposed or cancelled appointments can be missing start/end dates (`(start.exists() and end.exists()) or (status in ('proposed' | 'cancelled'))`) app-2: Either start and end are specified, or neither (`start.empty() xor end.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.
Short | Logical 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.
Control | 0..1
Type | id
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
4. Appointment.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Summary | true
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.
Short | A 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. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
Control | 0..1
Type | uri
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
8. Appointment.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Common Languages (extensible to `http://hl7.org/fhir/ValueSet/languages|3.0.2` ) A human language.
Additional Bindings | Purpose
All Languages | Max Binding
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
10. Appointment.text
Definition | A human-readable narrative that contains a summary of the resource, and may 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.
Short | Text 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 in formation is added later.
Control | 0..1 This element is affected by the following invariants: dom-1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
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.
Short | Contained, 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.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
14. Appointment.extension
Definition | Changed: May be used to represent additional information that is not part of the basic definition of the resource. In order 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.
Short | Changed:Additional Content defined by implementations
Comments | Added: 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
16. 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. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Alternate Names | extensions, user content
18. Appointment.identifier
Definition | Changed: 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 | Changed:External Ids for this item
Note | This is a business identifier, not a resource identifier (see discussion)
Control | Changed:0..*
Type | Identifier
Summary | true
20. 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.
Short | Changed:proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error
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.
Control | 1..1
Binding | The codes SHALL be taken from AppointmentStatus (required to `http://hl7.org/fhir/ValueSet/appointmentstatus|3.0.2` ) The free/busy status of an appointment.
Type | code
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
22. Appointment.serviceCategory
Definition | Changed: A broad categorisation of the service that is to be performed during this appointment.
Short | Changed:A broad categorisation of the service that is to be performed during this appointment
Control | 0..1
Binding | For example codes, see ServiceCategory (example to `http://hl7.org/fhir/ValueSet/service-category|3.0.2` )
Type | CodeableConcept
Summary | true
24. Appointment.serviceType
Definition | Changed: The specific service that is to be performed during this appointment.
Short | Changed:The specific service that is to be performed during this appointment
Control | 0..*
Binding | For example codes, see ServiceType (example to `http://hl7.org/fhir/ValueSet/service-type|3.0.2` )
Type | CodeableConcept
Summary | true
26. Appointment.specialty
Definition | The specialty of a practitioner that would be required to perform the service requested in this appointment.
Short | The specialty of a practitioner that would be required to perform the service requested in this appointment
Control | 0..*
Binding | The codes SHOULD be taken from Practice Setting Code Value Set (preferred to `http://hl7.org/fhir/ValueSet/c80-practice-codes|20091109` )
Type | CodeableConcept
Summary | true
28. Appointment.appointmentType
Definition | Changed: The style of appointment or patient that has been booked in the slot (not service type).
Short | Changed:The style of appointment or patient that has been booked in the slot (not service type)
Control | 0..1
Binding | The codes SHOULD be taken from v2 Appointment reason codes (preferred to `http://hl7.org/fhir/ValueSet/v2-0276|2.8.2` )
Type | CodeableConcept
Summary | true
30. Appointment.reason
Definition | Changed: The reason that this appointment is being scheduled. This is more clinical than administrative.
Short | Changed:Reason this appointment is scheduled
Control | 0..*
Binding | The codes SHOULD be taken from Encounter Reason Codes (preferred to `http://hl7.org/fhir/ValueSet/encounter-reason|3.0.2` ) The Reason for the appointment to take place.
Type | CodeableConcept
Summary | true
32. Appointment.indication
Definition | Changed: 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.
Short | Changed:Reason the appointment is to takes place (resource)
Control | 0..*
Type | Reference(Condition, Procedure)
34. 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).
Short | Used 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.
Control | 0..1
Type | unsignedInt
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
36. 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.
Short | Changed:Shown on a subject line in a meeting request, or appointment list
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
38. Appointment.supportingInformation
Definition | Additional information to support the appointment provided when making the appointment.
Short | Additional information to support the appointment
Control | 0..*
Type | Reference(Resource)
40. Appointment.start
Definition | Changed: Date/Time that the appointment is to take place.
Short | Changed:When appointment is to take place
Control | 0..1
Type | instant
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
42. Appointment.end
Definition | Changed: Date/Time that the appointment is to conclude.
Short | Changed:When appointment is to conclude
Control | 0..1
Type | instant
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
44. Appointment.minutesDuration
Definition | Changed: Number of minutes that the appointment is to take. This can be less than the duration between the start and end times (where actual time of appointment is only an estimate or is a planned appointment request).
Short | Changed:Can be less than start/end (e.g. estimate)
Control | 0..1
Type | positiveInt
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
46. Appointment.slot
Definition | The slots from the participants' schedules that will be filled by the appointment.
Short | The slots that this appointment is filling
Control | 0..*
Type | Reference(Slot)
48. Appointment.created
Definition | Changed: 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 | Changed:The 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.
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
50. Appointment.comment
Definition | Changed: Additional comments about the appointment.
Short | Changed:Additional 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.
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
52. Appointment.incomingReferral
Definition | Changed: The referral request this appointment is allocated to assess (incoming referral).
Short | The ReferralRequest provided as information to allocate to the Encounter
Control | 0..*
Type | Reference(ReferralRequest)
54. Appointment.participant
Definition | Changed: List of participants involved in the appointment.
Short | Changed:Participants involved in appointment
Control | 1..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() | (children().count() > id.count())`) app-1: Either the type or actor on the participant SHALL be specified (`type.exists() or actor.exists()`)
56. 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.
Short | xml:id (or equivalent in JSON)
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
XML Format | In the XML format, this property is represented as an attribute.
58. Appointment.participant.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. In order 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.
Short | Additional 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.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
60. 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because No Modifier Reason provideed in previous versions of FHIR
Summary | true
Alternate Names | extensions, user content, modifiers
62. Appointment.participant.type
Definition | Role of participant in the appointment.
Short | Role 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ParticipantType (extensible to `http://hl7.org/fhir/ValueSet/encounter-participant-type|3.0.2` ) Role of participant in encounter.
Type | CodeableConcept
Summary | true
64. Appointment.participant.actor
Definition | A Person, Location/HealthcareService or Device that is participating in the appointment.
Short | Person, Location/HealthcareService or Device
Control | 0..1
Type | Reference(Patient, Practitioner, RelatedPerson, Device, HealthcareService, Location)
Summary | true
66. Appointment.participant.required
Definition | Is this participant required to be present at the meeting. This covers a use-case where 2 doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.
Short | Changed:required | optional | information-only
Control | 0..1
Binding | The codes SHALL be taken from ParticipantRequired (required to `http://hl7.org/fhir/ValueSet/participantrequired|3.0.2` ) Is the Participant required to attend the appointment.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
68. Appointment.participant.status
Definition | Changed: Participation status of the actor.
Short | Changed:accepted | declined | tentative | needs-action
Control | 1..1
Binding | The codes SHALL be taken from ParticipationStatus (required to `http://hl7.org/fhir/ValueSet/participationstatus|3.0.2` ) The Participation status of an appointment.
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
70. Appointment.requestedPeriod
Definition | A set of date ranges (potentially including times) that the appointment is preferred to be scheduled within. When using these values, the minutes duration should be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time.
Short | Potential date/time interval(s) requested to allocate the appointment within
Comments | This does not introduce a capacity for recurring appointments.
Control | 0..*
Type | Period