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).

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.

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 free/busy status of an appointment.

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Very often the text is the same as a displayName of one of the codings.

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

Classification of the encounter.

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

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

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.

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

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

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.

The Reason for the appointment to take place.

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).

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.

Indicates the urgency of the appointment.

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.

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).

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

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.

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

The previous appointment in a series of related appointments.

This property is intended for use when representing a series of related appointments. For example, in a nuclear medicine procedure, where there is an appointment for the injection of the isotopes, and then a subsequent appointment for the scan, the scan appointment would refer to the injection appointment via Appointment.previousAppointment. For representing recurring appointments, see the guidance on recurring vs. series appointments.

The originating appointment in a recurring set of related appointments.

This property is intended for use when representing a recurring set of related appointments.

For example, a patient undergoing physical therapy may have a recurring appointment every Tuesday and Thursday. Each occurrence of the set will refer to the originating appointment, which contains the recurring template information. For representing appointment series, see the guidance on recurring vs. series appointments.

Date/Time that the appointment is to conclude.

If actual start/end times are not known then the requested period start/end can be used.

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.

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.

This does not introduce a capacity for recurring appointments.

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

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

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

Additional notes/comments about the appointment.

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.

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).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

Role of participant in the appointment.

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.

Role of participant in encounter.

Participation period of the actor.

The individual, device, location, or service participating in the appointment.

Where a CareTeam is provided, this does not imply that the entire team is included, just a single member from the group with the appropriate role. Where multiple members are required, please include the CareTeam the required number of times.

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

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'.

Participation status of the actor.

The Participation status of an appointment.

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

This appointment varies from the recurring pattern.

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.

The timezone of the recurring appointment occurrences.

IANA Timezones (BCP 175)

How often the appointment series should recur.

IANA Timezones (BCP 175)

Recurring appointments will not occur after this date.

How many appointments are planned in the recurrence.

The list of specific dates that will have appointments generated.

Indicates that recurring appointments should occur on Mondays.

Indicates that recurring appointments should occur on Tuesdays.

Indicates that recurring appointments should occur on Wednesdays.

Indicates that recurring appointments should occur on Thursdays.

Indicates that recurring appointments should occur on Fridays.

Indicates that recurring appointments should occur on Saturdays.

Indicates that recurring appointments should occur on Sundays.

The interval defines if the recurrence is every nth week. The default is every week, so it is expected that this value will be 2 or more.

e.g. For recurring every second week this interval would be 2, or every third week the interval would be 3.

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

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

The set of weeks in a month.

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

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

The days of the week.

Indicates that recurring appointments should occur every nth month.

Appointment recurs every nth year.

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

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.

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

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.