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type: resourceresource: Appointment

Appointment

Introduction

Scope and Usage

Appointment resources are used to provide information about a planned meeting that may be in the future or past. The resource only describes a single meeting, a series of repeating visits would require multiple appointment resources to be created for each instance. Examples include a scheduled surgery, a follow-up for a clinical visit, a scheduled conference call between clinicians to discuss a case (where the patient is a subject, but not a participant), the reservation of a piece of diagnostic equipment for a particular use, etc. The visit scheduled by an appointment may be in person or remote (by phone, video conference, etc.) All that matters is that the time and usage of one or more individuals, locations and/or pieces of equipment is being fully or partially reserved for a designated period of time.

This definition takes the concepts of appointments in a clinical setting and also extends them to be relevant in the community healthcare space, and to ease exposure to other appointment / calendar standards widely used outside of healthcare.

The basic workflow to create an appointment

There are 2 typical workflows that occur with appointments

Recurring Appointments

There are 2 main forms of recurring appointments recognized by FHIR:

Recurring (template/pattern)

The recurring appointment uses the recurrenceTemplate property to define when all of the occurrences of the appointment should occur. This value only exists on the original booking for the appointment, for all the subsequent occurrences the originatingAppointment refers back to original for the template details.

Accepting a recurring appointment can be done either as accepting the entire series (using AppointmentResponse.recurring=true) or can accept each occurrence individually (using AppointmentResponse.recurring=false along with AppointmentResponse.occurrenceDate or AppointmentResponse.recurrenceId to indicate which repetition specifically)

Note that in the template the timezone property defines which timezone the start/end times apply. This is required as the time properties only have the offset (+10), and not the zone (Australia/Melbourne), which means that they cannot be used by the template to generate 9am every Wednesday all year (as Melbourne changes to +11 during daylight saving time).

Series (simple chain)

A series appointment has no template information, and thus don't use the recurrenceTemplate property. Often when first booked it is likely not known that it will become a series of bookings, and only on conclusion of the encounter it is decided to follow-up and then book a new appointment (or even book it later on) and relate the new booking to the previous in the series through the previousAppointment property. This style of recurring appointment likely won't use the originatingAppointment property either.

As each appointment in a series is a separate appointment and booked as needed, the acceptance of requests here is just as it would be normally if they didn't have a sequence.

As each occurrence is booked independently there are no specific issues with timezones, as each instance exactly defines when it occurs (there is no template).

[%stu-note dstu2%] We are seeking input from the implementer community on the recurring appointment functionality and specifically if there is a need for a "recur forever" or similar flag.

Feedback here. [%end-note%]

Boundaries and Relationships

Appointment Request/Response Pattern

When using a request-response style of appointment this is done using Appointment and AppointmentResponse resources.
The request is made in the form of an Appointment with a proposed or pending status, and the list of actors with a participation status of "needs-action".

Participants in the appointment respond with their acceptance (or not) to the appointment by creating AppointmentResponse resources.
Once all the participants have replied, then the Appointment resource is able to be updated with an overall status which collates the results of all the participants and presents the approved details of the appointment.

The participant type property can be used to represent a specific role that a practitioner is required to perform for the appointment. This could be specified without an actor when the actual practitioner is not known, and will be filled in closer to the scheduled time.
This property must be the same between the Appointment-participant and the AppointmentResponse so that the appropriate values can be allocated. If you need multiple actors of a specific type, then multiple participants with that type value are included on the appointment.

The Appointment resource represents an intention to perform a service. An Appointment does NOT represent an authorization. Authorization is typically provided via a ServiceRequest when required. Details about the fulfillment of the appointment are handled by the Encounter resource.

Appointment Statuses and Encounters

Appointments can be considered as Administrative only, and the Encounter is expected to have clinical implications. Both resources align with the Clinical Workflow Process Life Cycle pattern.

In general, it is expected that appointments will result in the creation of an Encounter. The encounter is typically created when the service starts, not when the patient arrives. When the patient arrives, an appointment can be marked with a status of Arrived.

In an Emergency Room context, the appointment Resource is probably not appropriate to be used. In these cases, an Encounter should be created.

The Appointment request pattern used is different from the order-response pattern used elsewhere in FHIR.
This is due to the close relationship to the iCal standard. Many non-clinical systems use generic non-health appointment systems which implement this standard, and the desire to integrate with the consumer who has no access to health based software is highly desirable.
The mappings to the iCal standard have been provided to guide implementation of gateways between FHIR servers and iCal systems.

Appointment Locations and Participation

The location of the appointment is to be defined by using a participant that references a Location or HealthcareService resource.
This permits the location to also have its availability checked via a schedule and any conflicts more easily managed.

Notes

Typical Status Transition Examples:

Typical flow of statuses for an appointment:

Activity DescriptionSlotAppointmentAppointment ResponseEncounter
The schedule is created/published <br/> (Role: Scheduler)freeBusyType = FREE
An appointment request is created after locating an available slot <br/> (Role: Requester)status = pending <br/> participant.status = needs-action
The appointment request is processed and the slot status updated <br/> (Role: Scheduler)freeBusyType = BUSY-TENTATIVE
The appointment is accepted as described - by all participants <br/> (Role: Participant(s))participantStatus = accepted
The appointment is confirmed as accepted by all participants <br/> (Role: Scheduler)freeBusyType = BUSYstatus = booked <br/> participant.status = accepted
Optional: Preparation for the appointment begins - could be preparing a room for the appointment, etc. <br/> (Role: Participants/Admin)status = planned (optional) <br/> location.status = planned
The patient arrives for the appointment, often sitting in a waiting room <br/> (Role: Admin)status = arrivedstatus = in-progress
subjectStatus = arrived
location.status = active
The practitioner and the patient meet and the provision of the service begins/occurs <br/> (Role: Participant(s)/Admin)status = fulfilledstatus = in-progress <br/> subjectStatus = receiving-care
The care provision concludes and the patient leaves, some administrative and/or cleanup actions take place <br/> (Role: Practitioner(s)/Admin/Billing - excluding patient)status = discharged <br/> subjectStatus = departed
The encounter concludes, all paperwork has been completed and the encounter can be closed off <br/> (Role: Practitioner(s)/Admin)status = finished <br/> location.status = completed

Flow for the rejection/cancellation of an appointment

Activity DescriptionSlotAppointmentAppointment Response
The schedule is created/published <br/> (Role: Scheduler)freeBusyType = FREE
An appointment request is created <br/> (Role: Requester)status = pending <br/> participant.status = needs-action
The appointment request is processed and the slot status updated <br/> (Role: Scheduler)freeBusyType = BUSY-TENTATIVE
Participant declines the Appointment <br/> (Role: Participant)participantStatus = declined
The appointment is cancelled (typically the cancellationDate will be populated, along with a cancellation reason if applicable, this is often selected by the scheduler as could be used by the billing engine) <br/> (Role: Scheduler)freeBusyType = FREEstatus = cancelled
cancellationDate = (date of cancellation)
cancellationReason = (cancellation reason if applicable)
participant.status = declined

Flow for re-negotiation:

Activity DescriptionSlotAppointmentAppointment Response
The schedule is created/published <br/> (Role: Scheduler)freeBusyType = FREE
An appointment is requested (e.g. with Brian and Peter) <br/> (Role: Requester)status = proposed
participant(Brian).status = needs-action
participant(Peter).status = needs-action
The schedule is updated to inform others of interest in the slot <br/> (Role: Scheduler)freeBusyType = BUSY-TENTATIVE
Brian accepts the appointment <br/> (Role: Participant-Brian)(Brian).participantStatus = accepted
Appointment is updated with Brian's status <br/> (Role: Scheduler)status = pending <br/> participant(Brian).status = accepted
Peter suggests a new time <br/> (Role: Participant-Peter)(Peter).participantStatus = tentative <br/> (with new time)
Appointment is updated with new time, and indicates that action is needed by both participants <br/> (Role: Scheduler)(new time details updated)
participant(Brian).status = needs-action
participant(Peter).status = needs-action
Brian accepts the appointment <br/> (Role: Participant-Brian)(Brian).participantStatus = accepted
Appointment updated <br/> (Role: Scheduler)participant(Brian).status = accepted
<br/> (Role: Participant-Peter)(Peter).participantStatus = accepted
Appointment updated <br/> (Role: Scheduler)freeBusyType = BUSYstatus = booked <br/> participant(Peter).status = accepted

Flow for a patient no-show:

Activity DescriptionSlotAppointmentAppointment ResponseEncounter
(from typical status flow)freeBusyType = BUSYstatus = booked <br/> participant.status = accepted
Appointment is updated as a noshow <br/> (Role: Scheduler/Admin)status = noshow(no encounter created)

Flow for a patient waitlist:

Activity DescriptionAppointment (inconvenient)Appointment (preferred)
An appointment is booked for an inconvenient time using a typical status flowstatus = booked <br/> participant.status = accepted
Waitlist appointment createdstatus = booked <br/> participant.status = acceptedstatus = waitlist <br/> requestedPeriod = (more convenient time period)
Patient notified of availability of a better slotstatus = bookedstatus = proposed <br/> participant.status = needs-action
Patient accepts better slotstatus = cancelledstatus = booked <br/> participant.status = accepted

Notes:

Insurance for Appointments

When appointments are scheduled, often insurance information is collected. This may be a single coverage, or multiple coverages. To document this preliminary coverage information, Appointment.account may be used to reference an Account which would contain the ordered list of Coverages that are expected to apply to the Appointment.

Payment Authorization for Appointments

Prior authorization for an Appointment would involve a Claim (to submit the prior authorization request) and a ClaimResponse (to receive the prior authorization approval). In this case, the Claim and ClaimResponse associated with the prior auth would reference the planned Appointment that was authorized. How the association between the prior authorization and the authorized services is described may vary by jurisdiction (e.g., Da Vinci PAS in the US).

[%stu-note dstu%] Implementer feedback is sought on the values for Appointment.priority and how interoperable they are. Using an extension to record a CodeableConcept for named values may be tested at a future Connectathon.
Implementer feedback is also sought to clarify desired relationship linkages between ServiceCategory, ServiceType and Specialty, along with how they have approached the definition.

Feedback here. [%end-note%]

StructureDefinition

Elements (Simplified)

Mappings

Resource Packs

list-Appointment-packs.xml

<?xml version="1.0" encoding="UTF-8"?>

<List xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../publish/List.xsd">
  <id value="Appointment-packs"/>
  <status value="current"/>
  <mode value="working"/>
</List>

Search Parameters

Full Search Parameters

Examples

Full Examples

Mapping Exceptions

appointment-fivews-mapping-exceptions.xml

Divergent Elements

Unmapped Elements

appointment-request-mapping-exceptions.xml

Divergent Elements

Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

A status of completed for a "doNotPerform" request indicates that the period of non-performance is now satisfied and the request no longer holds. | resource=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.

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.

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.

Unmapped Elements