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Patient Administration Work Group Maturity Level : 3   Trial Use Security Category : Patient Compartments : Device , Patient , Practitioner , RelatedPerson

Detailed Descriptions for the elements in the Appointment resource.

Appointment
Element Id 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).

Cardinality 0..*
Type DomainResource
Invariants
Defined on this element
app-2 Rule Either start and end are specified, or neither start.exists() = end.exists()
app-3 Rule Only proposed or cancelled appointments can be missing start/end dates (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4 Rule 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')
Appointment.identifier
Element Id 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).

Note This is a business identifier, not a resource identifier (see discussion )
Cardinality 0..*
Type Identifier
Summary true
Appointment.status
Element Id 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.

Cardinality 1..1
Terminology Binding AppointmentStatus ( Required )
Type code
Is Modifier true (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)
Summary true
Comments

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

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

Appointment.cancelationReason
Element Id 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.

Cardinality 0..1
Terminology Binding Appointment cancellation reason ( Example )
Type CodeableConcept
Summary true
Appointment.serviceCategory
Element Id Appointment.serviceCategory
Definition

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

Cardinality 0..*
Terminology Binding Service category ( Example )
Type CodeableConcept
Summary true
Appointment.serviceType
Element Id Appointment.serviceType
Definition

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

Cardinality 0..*
Terminology Binding Service type ( Example )
Type CodeableConcept
Summary true
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 Id Appointment.specialty
Definition

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

Cardinality 0..*
Terminology Binding Practice Setting Code Value Set ( Preferred )
Type CodeableConcept
Summary true
Appointment.appointmentType
Element Id Appointment.appointmentType
Definition

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

Cardinality 0..1
Terminology Binding v2 Appointment Reason Codes ( Preferred )
Type CodeableConcept
Summary true
Appointment.reasonCode
Element Id Appointment.reasonCode
Definition

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

Cardinality 0..*
Terminology Binding Encounter Reason Codes ( Preferred )
Type CodeableConcept
Summary true
Appointment.reasonReference
Element Id 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.

Cardinality 0..*
Type Reference ( Condition | Procedure | Observation | ImmunizationRecommendation )
Patterns Reference(Condition,Procedure,Observation,ImmunizationRecommendation): No common pattern
Appointment.priority
Element Id 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).

Cardinality 0..1
Type unsignedInt
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 Id 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.

Cardinality 0..1
Type string
Appointment.supportingInformation
Element Id Appointment.supportingInformation
Definition

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

Cardinality 0..*
Type Reference ( Any )
Appointment.start
Element Id Appointment.start
Definition

Date/Time that the appointment is to take place.

Cardinality 0..1
Type instant
Summary true
Appointment.end
Element Id Appointment.end
Definition

Date/Time that the appointment is to conclude.

Cardinality 0..1
Type instant
Summary true
Appointment.minutesDuration
Element Id 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.

Cardinality 0..1
Type positiveInt
Appointment.slot
Element Id Appointment.slot
Definition

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

Cardinality 0..*
Type Reference ( Slot )
Appointment.created
Element Id 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.

Cardinality 0..1
Type dateTime
Comments

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

Appointment.comment
Element Id Appointment.comment
Definition

Additional comments about the appointment.

Cardinality 0..1
Type string
Comments

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

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

Appointment.patientInstruction
Element Id 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).

Cardinality 0..1
Type string
Appointment.basedOn
Element Id Appointment.basedOn
Definition

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

Cardinality 0..*
Type Reference ( ServiceRequest )
Alternate Names incomingReferral
Appointment.participant
Element Id Appointment.participant
Definition

List of participants involved in the appointment.

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

Role of participant in the appointment.

Cardinality 0..*
Terminology Binding Participant type ( Extensible )
Type CodeableConcept
Summary true
Comments

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

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

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

Appointment.participant.actor
Element Id Appointment.participant.actor
Definition

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

Cardinality 0..1
Type Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location )
Patterns Reference(Patient,Practitioner,PractitionerRole,RelatedPerson,Device,HealthcareService,Location): Common patterns = Participant
Summary true
Appointment.participant.required
Element Id 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.

Cardinality 0..1
Terminology Binding ParticipantRequired ( Required )
Type code
Summary true
Appointment.participant.status
Element Id Appointment.participant.status
Definition

Participation status of the actor.

Cardinality 1..1
Terminology Binding ParticipationStatus ( Required )
Type code
Summary true
Appointment.participant.period
Element Id Appointment.participant.period
Definition

Participation period of the actor.

Cardinality 0..1
Type Period
Appointment.requestedPeriod
Element Id 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.

Cardinality 0..*
Type Period
Comments

This does not introduce a capacity for recurring appointments.