type: resource-definitionsresource: Appointment

Appointment Definitions

Appointment

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)

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..*

Constraints: app-5 | error | The start must be less than or equal to the end | start.exists() implies start <= end; app-4 | error | Cancellation reason is only used for appointments that have been cancelled, or noshow | cancellationReason.exists() implies (status='noshow' or status='cancelled'); app-3 | error | Only proposed or cancelled appointments can be missing start/end dates | (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist')); app-2 | error | Either start and end are specified, or neither | start.exists() = end.exists(); app-6 | warning | An appointment may have an originatingAppointment or recurrenceTemplate, but not both | originatingAppointment.exists().not() or recurrenceTemplate.exists().not(); app-7 | error | Cancellation date is only used for appointments that have been cancelled, or noshow | cancellationDate.exists() implies (status='noshow' or status='cancelled')

Mappings: workflow=Request; rim=Act[@moodCode <= 'INT']; ical=VEVENT; w5=workflow.scheduling

Appointment.identifier

External Ids for this item

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).

Cardinality: 0..*

Type: Identifier

Summary: true

Mappings: workflow=Request.identifier; w5=FiveWs.identifier; v2=SCH-1, SCH-2, ARQ-1, ARQ-2; rim=.id; ical=UID

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.

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.

Conditions: app-4, app-3, app-7

Cardinality: 1..1

Type: code

Binding: required:appointmentstatus

Summary: true

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)

Mappings: workflow=Request.status; w5=FiveWs.status; v2=SCH-25; rim=.statusCode; ical=STATUS

Appointment.cancellationReason

The coded reason for the appointment being cancelled

Definition: The coded reason for the appointment being cancelled. This is often used in reporting/billing/further processing to determine if further actions are required, or specific fees apply.

Conditions: app-4

Cardinality: 0..1

Type: CodeableConcept

Binding: example:appointment-cancellation-reason

Summary: true

Mappings: rim=n/a

Appointment.class

Classification when becoming an encounter

Definition: Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

Cardinality: 0..*

Type: CodeableConcept

Binding: preferred:EncounterClass

Summary: true

Mappings: w5=FiveWs.class; v2=PV1-2; rim=.inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code

Appointment.serviceCategory

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

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

Cardinality: 0..*

Type: CodeableConcept

Binding: example:service-category

Summary: true

Mappings: rim=n/a, might be inferred from the ServiceDeliveryLocation; ical=CATEGORIES

Appointment.serviceType

The specific service that is to be performed during this appointment

Definition: The 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.

Cardinality: 0..*

Type: CodeableReference

Binding: example:service-type

Summary: true

Mappings: workflow=Request.code; v2=ARQ-8, SCH-8 or ARQ-7, SCH-7 - note these are all user tables - review with trading partners which v2 field is used for serviceType concepts is recommended.; rim=n/a, might be inferred from the ServiceDeliveryLocation

Appointment.specialty

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

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

Cardinality: 0..*

Type: CodeableConcept

Binding: example:c80-practice-codes

Summary: true

Mappings: w5=FiveWs.class; rim=.performer.AssignedPerson.code

Appointment.appointmentType

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

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

Cardinality: 0..1

Type: CodeableConcept

Binding: preferred:v2-0276

Summary: true

Mappings: rim=.code; ical=CLASSIFICATION

Appointment.reason

Reason this appointment is scheduled

Definition: The reason that this appointment is being scheduled. This is more clinical than administrative. This can be coded, or as specified using information from another resource. When the patient arrives and the encounter begins it may be used as the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

Cardinality: 0..*

Type: CodeableReference

Binding: preferred:encounter-reason

Summary: true

Mappings: workflow=Request.reason; v2=AIS-3; rim=.reasonCode

Appointment.priority

Used to make informed decisions if needing to re-prioritize

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).

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.

Cardinality: 0..1

Type: CodeableConcept

Binding: example:v3-ActPriority

Mappings: workflow=Request.priority; w5=FiveWs.class; v2=ARQ-12, SCH-11.6 / TQ1-9; rim=.priorityCode; ical=PRIORITY

Appointment.description

Shown on a subject line in a meeting request, or appointment list

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 note field.

Cardinality: 0..1

Type: string

Mappings: v2=NTE-3; rim=.text; ical=SUMMARY

Appointment.replaces

Appointment replaced by this Appointment

Definition: Appointment replaced by this Appointment in cases where there is a cancellation, the details of the cancellation can be found in the cancellationReason property (on the referenced resource).

Cardinality: 0..*

Type: Reference(Appointment)

Mappings: workflow=Request.replaces; w5=FiveWs.context; rim=.inboundRelationship[@typeCode = 'SPRT'].observation; ical=ATTACH

Appointment.virtualService

Connection details of a virtual service (e.g. conference call)

Comments: There are two types of virtual meetings that often exist:

a persistent, virtual meeting room that can only be used for a single purpose at a time,
and a dynamic virtual meeting room that is generated on demand for a specific purpose.

Implementers may consider using Location.virtualService for persistent meeting rooms.

If each participant would have a different meeting link, an extension using the VirtualServiceContactDetail can be applied to the Appointment.participant BackboneElement.

Cardinality: 0..*

Type: VirtualServiceDetail

Mappings: rim=N/A

Appointment.supportingInformation

Additional information to support the appointment

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

Cardinality: 0..*

Type: Reference(Resource)

Can be less than start/end (e.g. estimate)

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

Mappings: workflow=Request.occurrence[x]; rim=.activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')].width; ical=DURATION (e.g. PT15M)

Appointment.requestedPeriod

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

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.

Comments: This does not introduce a capacity for recurring appointments.

Cardinality: 0..*

Type: Period

Mappings: workflow=Request.occurrence[x]; v2=ARQ-11; rim=.activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')]

Appointment.slot

The slots that this appointment is filling

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

Cardinality: 0..*

Type: Reference(Slot)

Mappings: rim=.outboundRelationship[@typeCode = 'REFR'].act[@classCode = 'ACT'][@moodCode = 'SLOT']

Appointment.account

The set of accounts that may be used for billing for this Appointment

Definition: The set of accounts that is expected to be used for billing the activities that result from this Appointment.

Comments: The specified account(s) could be those identified during pre-registration workflows in preparation for an upcoming Encounter.

Cardinality: 0..*

Type: Reference(Account)

Mappings: rim=.pertains.A_Account

Appointment.created

The date that this appointment was initially 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.

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.

Cardinality: 0..1

Type: dateTime

Mappings: workflow=Request.authoredOn; rim=.author.time; ical=CREATED

Appointment.cancellationDate

When the appointment was cancelled

Definition: The date/time describing when the appointment was cancelled.

Comments: If the appointment was cancelled multiple times, this would reflect the most recent cancellation.

Conditions: app-7

Cardinality: 0..1

Type: dateTime

Appointment.note

Additional comments

Definition: Additional notes/comments about the appointment.

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

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

Typically only the concept.text will be used, however occasionally a reference to some generic documentation (or specific) and also supports coded instructions if/when they are required.

Cardinality: 0..*

Type: Annotation

Mappings: workflow=Request.note; v2=NTE-3; rim=.subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value; ical=DESCRIPTION (for internal use)

Appointment.patientInstruction

Detailed information and instructions for the patient

Definition: While Appointment.note contains information for internal use, Appointment.patientInstructions is used to capture patient facing information about the Appointment (e.g. please bring your referral or fast from 8pm night before).

Cardinality: 0..*

Type: CodeableReference

Mappings: v2=NTE-3; rim=.subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value; ical=DESCRIPTION (for patient use)

Appointment.basedOn

The request this appointment is allocated to assess

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

Aliases: incomingReferral

Cardinality: 0..*

Type: Reference(CarePlan, DeviceRequest, MedicationRequest, ServiceRequest, RequestOrchestration, NutritionOrder, VisionPrescription)

Mappings: workflow=Request.basedOn; rim=.outboundRelationship[@typeCode = 'FLFS'].act[@classCode < 'ActCareProvisionRequestType'][@moodCode = 'RQO']

Appointment.subject

The patient or group associated with the appointment

Mappings: w5=FiveWs.who; v2=PID-3-Patient ID List | AIL-3 | AIG-3 | AIP-3; rim=performer.person | reusableDevice.manufacturedDevice | subject.patient | location.serviceDeliveryLocation; ical=ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"

Appointment.participant.required

The participant is required to attend (optional when false)

Definition: Whether this participant is required to be present at the meeting. If false, the participant is optional.

Comments: For the use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present include the patient in the subject field, but do not include them as a participant - this was formerly done prior to R5 with required='information-only'.

Cardinality: 0..1

Type: boolean

Summary: true

Mappings: rim=(performer | reusableDevice | subject | location).@performInd; ical=ROLE=REQ-PARTICIPANT (roleparam)

Appointment.participant.status

accepted | declined | tentative | needs-action

Definition: Participation status of the actor.

Cardinality: 1..1

Type: code

Binding: required:participationstatus

Summary: true

Mappings: v2=AIP-12, AIG-14; rim=(performer | reusableDevice | subject | location).statusCode; ical=ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam | partstatparam)

Appointment.recurrenceId

The sequence number in the recurrence

Definition: The sequence number that identifies a specific appointment in a recurring pattern.

Cardinality: 0..1

Type: positiveInt

Mappings: rim=N/A

Appointment.occurrenceChanged

Indicates that this appointment varies from a recurrence pattern

Definition: This appointment varies from the recurring pattern.

Comments: For example, if a patient has physical therapy appointments every Tuesday and Thursday, but due to a national holiday, a single occurrence was rescheduled to a different day, while the rest of the recurring series remained on Tuesday / Thursday.

Cardinality: 0..1

Type: boolean

Mappings: rim=N/A

Appointment.recurrenceTemplate

Details of the recurrence pattern/template used to generate occurrences

Definition: The details of the recurrence pattern or template that is used to generate recurring appointments.

Conditions: app-6

Cardinality: 0..*

Type: BackboneElement

Mappings: rim=N/A

Appointment.recurrenceTemplate.timezone

The timezone of the occurrences

Definition: The timezone of the recurring appointment occurrences.

Cardinality: 0..1

Type: CodeableConcept

Binding: required:timezones

Mappings: ical=TZID; rim=N/A

Appointment.recurrenceTemplate.recurrenceType

The frequency of the recurrence

Definition: How often the appointment series should recur.

Cardinality: 1..1

Type: CodeableConcept

Binding: preferred:appointment-recurrrence-type

Mappings: ical=FREQ

Appointment.recurrenceTemplate.lastOccurrenceDate

The date when the recurrence should end

Definition: Recurring appointments will not occur after this date.

Cardinality: 0..1

Type: date

Mappings: ical=UNTIL

Appointment.recurrenceTemplate.occurrenceCount

The number of planned occurrences

Definition: How many appointments are planned in the recurrence.

Cardinality: 0..1

Type: positiveInt

Mappings: ical=COUNT

Appointment.recurrenceTemplate.occurrenceDate

Specific dates for a recurring set of appointments (no template)

Appointment.recurrenceTemplate.monthlyTemplate

Information about monthly recurring appointments

Definition: Information about monthly recurring appointments.

Cardinality: 0..1

Type: BackboneElement

Appointment.recurrenceTemplate.monthlyTemplate.dayOfMonth

Recurs on a specific day of the month

Definition: Indicates that appointments in the series of recurring appointments should occur on a specific day of the month.

Cardinality: 0..1

Type: positiveInt

Appointment.recurrenceTemplate.monthlyTemplate.nthWeekOfMonth

Indicates which week of the month the appointment should occur

Definition: Indicates which week within a month the appointments in the series of recurring appointments should occur on.

Cardinality: 0..1

Type: Coding

Binding: required:week-of-month

Appointment.recurrenceTemplate.monthlyTemplate.dayOfWeek

Indicates which day of the week the appointment should occur

Definition: Indicates which day of the week the recurring appointments should occur each nth week.

Comments: This property is intended to be used with Appointment.recurrenceTemplate.monthly.nthWeek.

Cardinality: 0..1

Type: Coding

Binding: required:days-of-week

Appointment.recurrenceTemplate.monthlyTemplate.monthInterval

Recurs every nth month

Definition: Indicates that recurring appointments should occur every nth month.

Cardinality: 1..1

Type: positiveInt

Appointment.recurrenceTemplate.yearlyTemplate

Information about yearly recurring appointments

Definition: Information about yearly recurring appointments.

Cardinality: 0..1

Type: BackboneElement

Appointment.recurrenceTemplate.yearlyTemplate.yearInterval

Recurs every nth year

Definition: Appointment recurs every nth year.

Cardinality: 1..1

Type: positiveInt

Appointment.recurrenceTemplate.excludingDate

Any dates that should be excluded from the series

Definition: Any dates, such as holidays, that should be excluded from the recurrence.

Comments: excludingDate is an alternative to excludingRecurrenceId. You may say either that 12/25/XXXX should be excluded using excludingDate, or you may indicate the recurrenceId of the appointment that would fall on the excluded date in the excludingRecurrenceId property.

Cardinality: 0..*

Type: date

Mappings: ical=EXDATE

Appointment.recurrenceTemplate.excludingRecurrenceId

Any recurrence IDs that should be excluded from the recurrence

Definition: Any dates, such as holidays, that should be excluded from the recurrence.

Comments: excludingRecurrenceId is an alternative to excludingDate. You may say either that 12/25/XXXX should be excluded using excludingDate, or you may indicate the recurrenceId of the appointment that would fall on the excluded date in the excludingRecurrenceId property.

Cardinality: 0..*

Type: positiveInt