Pan-Canadian eReferral-eConsult (CA:eReC) iGuide

DRAFT - The specification is currently in development and subject to significant change. It is not ready for limited roll-out or production level use.

Appointment (CA:eReC)

Structure Definition: Appointment Profile

Canonical URL: https://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Appointment

Simplifier project page: Appointment

Derived from: Appointment (R4)

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work

Appointment	I		Appointment	There are no (further) constraints on this element Element id Appointment Short description 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). Data type Appointment Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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 or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` app-4: 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')` app-3: Only proposed or cancelled appointments can be missing start/end dates `(start.exists() and end.exists()) or (status in ('proposed' \| 'cancelled' \| 'waitlist'))` app-2: Either start and end are specified, or neither `start.exists() = end.exists()` Mappings rim: Entity. Role, or Act workflow: Request rim: Act[@moodCode <= 'INT'] ical: VEVENT
id	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta	Σ	0..1	Meta	Element id Appointment.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Comments The MustSupport flag on this element has been relaxed in this version until further confirmation of the use of meta.profile (outside of use for certain validation suites) and impact can be assessed by the working group. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Appointment.implicitRules Short description A set of rules under which this content was created 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id Appointment.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can 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. 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 information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Appointment.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources 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. 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
virtualService	I	0..*	Extension	Element id Appointment.extension:virtualService Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-Appointment.virtualService Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Appointment.identifier Short description 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Request.identifier w5: FiveWs.identifier v2: SCH-1, SCH-2, ARQ-1, ARQ-2 rim: .id ical: UID
status	S Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.status Short description proposed \| pending \| booked \| arrived \| fulfilled \| cancelled \| noshow \| entered-in-error \| checked-in \| waitlist 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. Data type code Binding The free/busy status of an appointment. AppointmentStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.status w5: FiveWs.status v2: SCH-25 rim: .statusCode ical: STATUS
cancelationReason	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Appointment.cancelationReason Short description The coded reason for the appointment being cancelled 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding AppointmentCancellationReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
serviceCategory	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Appointment.serviceCategory Short description 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding ServiceCategory (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: n/a, might be inferred from the ServiceDeliveryLocation ical: CATEGORIES
serviceType	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Appointment.serviceType Short description 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. Data type CodeableConcept Binding ServiceType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code rim: n/a, might be inferred from the ServiceDeliveryLocation
specialty	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.specialty Short description 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding PracticeSettingCodeValueSet (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .performer.AssignedPerson.code
appointmentType	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.appointmentType Short description 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). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding v2.0276 (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: ARQ-7 rim: .code ical: CLASSIFICATION
reasonCode	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.reasonCode Short description Coded reason this appointment is scheduled Definition The coded reason that this appointment is being scheduled. This is more clinical than administrative. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The Reason for the appointment to take place. EncounterReasonCodes (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.reasonCode v2: AIS-3, SCH-7 rim: .reasonCode
reasonReference	I	0..*	Reference(Condition \| Procedure \| Observation \| ImmunizationRecommendation)	There are no (further) constraints on this element Element id Appointment.reasonReference Short description Reason the appointment is to take place (resource) 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. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition \| Procedure \| Observation \| ImmunizationRecommendation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference rim: .inboundRelationship[@typeCode = 'RSON'].observation
priority		0..1	unsignedInt	There are no (further) constraints on this element Element id Appointment.priority Short description 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. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.priority w5: FiveWs.class v2: ARQ-12, SCH-11.6 / TQ1-9 rim: .priorityCode ical: PRIORITY
description	S	0..1	string	There are no (further) constraints on this element Element id Appointment.description Short 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 comment field. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: NTE-3 rim: .text ical: SUMMARY
supportingInformation	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element id Appointment.supportingInformation Short description Additional information to support the appointment Definition Additional information to support the appointment provided when making the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo w5: FiveWs.context rim: .inboundRelationship[@typeCode = 'SPRT'].observation ical: ATTACH
start	S Σ	0..1	instant	There are no (further) constraints on this element Element id Appointment.start Short description When appointment is to take place Definition Date/Time that the appointment is to take place. Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.init v2: ARQ-11.1, SCH-11.4 / TQ1-7 rim: .effectiveTime.low ical: DTSTART
end	S Σ	0..1	instant	There are no (further) constraints on this element Element id Appointment.end Short description When appointment is to conclude Definition Date/Time that the appointment is to conclude. Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.done[x] v2: SCH-11.5 / TQ1-8/ calculated based on the start and the duration which is in ARQ-9 rim: .effectiveTime.high ical: DTEND
minutesDuration		0..1	positiveInt	There are no (further) constraints on this element Element id Appointment.minutesDuration Short description 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. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] rim: .activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')].width ical: DURATION (e.g. PT15M)
slot	I	0..*	Reference(Slot)	There are no (further) constraints on this element Element id Appointment.slot Short description The slots that this appointment is filling Definition The slots from the participants' schedules that will be filled by the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Slot) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .outboundRelationship[@typeCode = 'REFR'].act[@classCode = 'ACT'][@moodCode = 'SLOT']
created	S	0..1	dateTime	There are no (further) constraints on this element Element id Appointment.created Short description 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. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.authoredOn rim: .author.time ical: CREATED
comment	S	0..1	string	There are no (further) constraints on this element Element id Appointment.comment Short description Additional comments Definition Additional comments about the appointment. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.note v2: NTE-3 rim: .subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value ical: DESCRIPTION (for internal use)
patientInstruction	S	0..1	string	There are no (further) constraints on this element Element id Appointment.patientInstruction Short description Detailed information and instructions for the patient 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). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: NTE-3 rim: .subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value ical: DESCRIPTION (for patient use)
basedOn	I	0..*	Reference(ServiceRequest)	Element id Appointment.basedOn Short description The service request this appointment is allocated to assess Alternate names incomingReferral Definition The service request this appointment is allocated to assess (e.g. incoming referral or procedure request). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(ServiceRequest) Allowed aggregation: referenced Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.basedOn rim: .outboundRelationship[@typeCode = 'FLFS'].act[@classCode < 'ActCareProvisionRequestType'][@moodCode = 'RQO']
participant	S I	1..*	BackboneElement	There are no (further) constraints on this element Element id Appointment.participant Short description Participants involved in appointment Definition List of participants involved in the appointment. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` app-1: Either the type or actor on the participant SHALL be specified `type.exists() or actor.exists()` Mappings rim: n/a workflow: Request.performer, Request.subject v2: PID, AIP, AIG, AIL rim: performer \| reusableDevice \| subject \| location ical: ATTENDEE component to be created
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
type	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.participant.type Short description Role of participant in the appointment Definition 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. Data type CodeableConcept Binding Role of participant in encounter. ParticipantType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: AIP-4, AIG-4 rim: (performer \| reusableDevice \| subject \| location).@typeCode ical: n/a
actor	S Σ I	0..1	Reference(Patient \| PractitionerRole \| Location)	Element id Appointment.participant.actor Short description Person, Location/HealthcareService or Device Definition A Person, Location/HealthcareService or Device that is participating in the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient \| PractitionerRole \| Location) Allowed aggregation: referenced Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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"
required	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant.required Short description required \| optional \| information-only 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Is the Participant required to attend the appointment. ParticipantRequired (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: (performer \| reusableDevice \| subject \| location).@performInd ical: ROLE=REQ-PARTICIPANT (roleparam)
status	S Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant.status Short description accepted \| declined \| tentative \| needs-action Definition Participation status of the actor. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The Participation status of an appointment. ParticipationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: AIP-12, AIG-14 rim: (performer \| reusableDevice \| subject \| location).statusCode ical: ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam \| partstatparam)
period	I	0..1	Period	There are no (further) constraints on this element Element id Appointment.participant.period Short description Participation period of the actor Definition Participation period of the actor. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
requestedPeriod	I	0..*	Period	There are no (further) constraints on this element Element id Appointment.requestedPeriod Short description 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. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] workflow: Request.occurrence[x] v2: ARQ-11 rim: .activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')]
text	S			There are no (further) constraints on this element Element id Appointment.text

Appointment	I		Appointment	There are no (further) constraints on this element Element id Appointment Short description 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). Data type Appointment Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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 or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` app-4: 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')` app-3: Only proposed or cancelled appointments can be missing start/end dates `(start.exists() and end.exists()) or (status in ('proposed' \| 'cancelled' \| 'waitlist'))` app-2: Either start and end are specified, or neither `start.exists() = end.exists()` Mappings rim: Entity. Role, or Act workflow: Request rim: Act[@moodCode <= 'INT'] ical: VEVENT
id	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta	Σ	0..1	Meta	Element id Appointment.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Comments The MustSupport flag on this element has been relaxed in this version until further confirmation of the use of meta.profile (outside of use for certain validation suites) and impact can be assessed by the working group. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Appointment.implicitRules Short description A set of rules under which this content was created 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id Appointment.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can 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. 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 information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Appointment.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources 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. 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
virtualService	I	0..*	Extension	Element id Appointment.extension:virtualService Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-Appointment.virtualService Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Appointment.identifier Short description 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Request.identifier w5: FiveWs.identifier v2: SCH-1, SCH-2, ARQ-1, ARQ-2 rim: .id ical: UID
status	S Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.status Short description proposed \| pending \| booked \| arrived \| fulfilled \| cancelled \| noshow \| entered-in-error \| checked-in \| waitlist 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. Data type code Binding The free/busy status of an appointment. AppointmentStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.status w5: FiveWs.status v2: SCH-25 rim: .statusCode ical: STATUS
cancelationReason	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Appointment.cancelationReason Short description The coded reason for the appointment being cancelled 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding AppointmentCancellationReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
serviceCategory	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Appointment.serviceCategory Short description 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding ServiceCategory (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: n/a, might be inferred from the ServiceDeliveryLocation ical: CATEGORIES
serviceType	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Appointment.serviceType Short description 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. Data type CodeableConcept Binding ServiceType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code rim: n/a, might be inferred from the ServiceDeliveryLocation
specialty	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.specialty Short description 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding PracticeSettingCodeValueSet (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .performer.AssignedPerson.code
appointmentType	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.appointmentType Short description 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). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding v2.0276 (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: ARQ-7 rim: .code ical: CLASSIFICATION
reasonCode	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.reasonCode Short description Coded reason this appointment is scheduled Definition The coded reason that this appointment is being scheduled. This is more clinical than administrative. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The Reason for the appointment to take place. EncounterReasonCodes (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.reasonCode v2: AIS-3, SCH-7 rim: .reasonCode
reasonReference	I	0..*	Reference(Condition \| Procedure \| Observation \| ImmunizationRecommendation)	There are no (further) constraints on this element Element id Appointment.reasonReference Short description Reason the appointment is to take place (resource) 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. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition \| Procedure \| Observation \| ImmunizationRecommendation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference rim: .inboundRelationship[@typeCode = 'RSON'].observation
priority		0..1	unsignedInt	There are no (further) constraints on this element Element id Appointment.priority Short description 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. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.priority w5: FiveWs.class v2: ARQ-12, SCH-11.6 / TQ1-9 rim: .priorityCode ical: PRIORITY
description	S	0..1	string	There are no (further) constraints on this element Element id Appointment.description Short 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 comment field. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: NTE-3 rim: .text ical: SUMMARY
supportingInformation	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element id Appointment.supportingInformation Short description Additional information to support the appointment Definition Additional information to support the appointment provided when making the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo w5: FiveWs.context rim: .inboundRelationship[@typeCode = 'SPRT'].observation ical: ATTACH
start	S Σ	0..1	instant	There are no (further) constraints on this element Element id Appointment.start Short description When appointment is to take place Definition Date/Time that the appointment is to take place. Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.init v2: ARQ-11.1, SCH-11.4 / TQ1-7 rim: .effectiveTime.low ical: DTSTART
end	S Σ	0..1	instant	There are no (further) constraints on this element Element id Appointment.end Short description When appointment is to conclude Definition Date/Time that the appointment is to conclude. Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.done[x] v2: SCH-11.5 / TQ1-8/ calculated based on the start and the duration which is in ARQ-9 rim: .effectiveTime.high ical: DTEND
minutesDuration		0..1	positiveInt	There are no (further) constraints on this element Element id Appointment.minutesDuration Short description 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. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] rim: .activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')].width ical: DURATION (e.g. PT15M)
slot	I	0..*	Reference(Slot)	There are no (further) constraints on this element Element id Appointment.slot Short description The slots that this appointment is filling Definition The slots from the participants' schedules that will be filled by the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Slot) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .outboundRelationship[@typeCode = 'REFR'].act[@classCode = 'ACT'][@moodCode = 'SLOT']
created	S	0..1	dateTime	There are no (further) constraints on this element Element id Appointment.created Short description 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. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.authoredOn rim: .author.time ical: CREATED
comment	S	0..1	string	There are no (further) constraints on this element Element id Appointment.comment Short description Additional comments Definition Additional comments about the appointment. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.note v2: NTE-3 rim: .subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value ical: DESCRIPTION (for internal use)
patientInstruction	S	0..1	string	There are no (further) constraints on this element Element id Appointment.patientInstruction Short description Detailed information and instructions for the patient 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). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: NTE-3 rim: .subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value ical: DESCRIPTION (for patient use)
basedOn	I	0..*	Reference(ServiceRequest)	Element id Appointment.basedOn Short description The service request this appointment is allocated to assess Alternate names incomingReferral Definition The service request this appointment is allocated to assess (e.g. incoming referral or procedure request). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(ServiceRequest) Allowed aggregation: referenced Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.basedOn rim: .outboundRelationship[@typeCode = 'FLFS'].act[@classCode < 'ActCareProvisionRequestType'][@moodCode = 'RQO']
participant	S I	1..*	BackboneElement	There are no (further) constraints on this element Element id Appointment.participant Short description Participants involved in appointment Definition List of participants involved in the appointment. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` app-1: Either the type or actor on the participant SHALL be specified `type.exists() or actor.exists()` Mappings rim: n/a workflow: Request.performer, Request.subject v2: PID, AIP, AIG, AIL rim: performer \| reusableDevice \| subject \| location ical: ATTENDEE component to be created
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
type	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.participant.type Short description Role of participant in the appointment Definition 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. Data type CodeableConcept Binding Role of participant in encounter. ParticipantType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: AIP-4, AIG-4 rim: (performer \| reusableDevice \| subject \| location).@typeCode ical: n/a
actor	S Σ I	0..1	Reference(Patient \| PractitionerRole \| Location)	Element id Appointment.participant.actor Short description Person, Location/HealthcareService or Device Definition A Person, Location/HealthcareService or Device that is participating in the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient \| PractitionerRole \| Location) Allowed aggregation: referenced Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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"
required	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant.required Short description required \| optional \| information-only 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Is the Participant required to attend the appointment. ParticipantRequired (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: (performer \| reusableDevice \| subject \| location).@performInd ical: ROLE=REQ-PARTICIPANT (roleparam)
status	S Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant.status Short description accepted \| declined \| tentative \| needs-action Definition Participation status of the actor. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The Participation status of an appointment. ParticipationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: AIP-12, AIG-14 rim: (performer \| reusableDevice \| subject \| location).statusCode ical: ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam \| partstatparam)
period	I	0..1	Period	There are no (further) constraints on this element Element id Appointment.participant.period Short description Participation period of the actor Definition Participation period of the actor. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
requestedPeriod	I	0..*	Period	There are no (further) constraints on this element Element id Appointment.requestedPeriod Short description 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. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] workflow: Request.occurrence[x] v2: ARQ-11 rim: .activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')]
text	S			There are no (further) constraints on this element Element id Appointment.text

Appointment	I		Appointment	There are no (further) constraints on this element Element id Appointment Short description 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). Data type Appointment Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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 or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` app-4: 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')` app-3: Only proposed or cancelled appointments can be missing start/end dates `(start.exists() and end.exists()) or (status in ('proposed' \| 'cancelled' \| 'waitlist'))` app-2: Either start and end are specified, or neither `start.exists() = end.exists()` Mappings rim: Entity. Role, or Act workflow: Request rim: Act[@moodCode <= 'INT'] ical: VEVENT
id	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta	Σ	0..1	Meta	Element id Appointment.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Comments The MustSupport flag on this element has been relaxed in this version until further confirmation of the use of meta.profile (outside of use for certain validation suites) and impact can be assessed by the working group. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Appointment.implicitRules Short description A set of rules under which this content was created 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. 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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id Appointment.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can 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. 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 information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Appointment.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources 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. 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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
virtualService	I	0..*	Extension	Element id Appointment.extension:virtualService Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-Appointment.virtualService Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Appointment.identifier Short description 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Request.identifier w5: FiveWs.identifier v2: SCH-1, SCH-2, ARQ-1, ARQ-2 rim: .id ical: UID
status	S Σ ?!	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.status Short description proposed \| pending \| booked \| arrived \| fulfilled \| cancelled \| noshow \| entered-in-error \| checked-in \| waitlist 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. Data type code Binding The free/busy status of an appointment. AppointmentStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.status w5: FiveWs.status v2: SCH-25 rim: .statusCode ical: STATUS
cancelationReason	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id Appointment.cancelationReason Short description The coded reason for the appointment being cancelled 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding AppointmentCancellationReason (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
serviceCategory	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Appointment.serviceCategory Short description 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding ServiceCategory (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: n/a, might be inferred from the ServiceDeliveryLocation ical: CATEGORIES
serviceType	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Appointment.serviceType Short description 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. Data type CodeableConcept Binding ServiceType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code rim: n/a, might be inferred from the ServiceDeliveryLocation
specialty	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.specialty Short description 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding PracticeSettingCodeValueSet (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .performer.AssignedPerson.code
appointmentType	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.appointmentType Short description 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). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding v2.0276 (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: ARQ-7 rim: .code ical: CLASSIFICATION
reasonCode	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.reasonCode Short description Coded reason this appointment is scheduled Definition The coded reason that this appointment is being scheduled. This is more clinical than administrative. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The Reason for the appointment to take place. EncounterReasonCodes (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.reasonCode v2: AIS-3, SCH-7 rim: .reasonCode
reasonReference	I	0..*	Reference(Condition \| Procedure \| Observation \| ImmunizationRecommendation)	There are no (further) constraints on this element Element id Appointment.reasonReference Short description Reason the appointment is to take place (resource) 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. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition \| Procedure \| Observation \| ImmunizationRecommendation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference rim: .inboundRelationship[@typeCode = 'RSON'].observation
priority		0..1	unsignedInt	There are no (further) constraints on this element Element id Appointment.priority Short description 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. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.priority w5: FiveWs.class v2: ARQ-12, SCH-11.6 / TQ1-9 rim: .priorityCode ical: PRIORITY
description	S	0..1	string	There are no (further) constraints on this element Element id Appointment.description Short 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 comment field. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: NTE-3 rim: .text ical: SUMMARY
supportingInformation	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element id Appointment.supportingInformation Short description Additional information to support the appointment Definition Additional information to support the appointment provided when making the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo w5: FiveWs.context rim: .inboundRelationship[@typeCode = 'SPRT'].observation ical: ATTACH
start	S Σ	0..1	instant	There are no (further) constraints on this element Element id Appointment.start Short description When appointment is to take place Definition Date/Time that the appointment is to take place. Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.init v2: ARQ-11.1, SCH-11.4 / TQ1-7 rim: .effectiveTime.low ical: DTSTART
end	S Σ	0..1	instant	There are no (further) constraints on this element Element id Appointment.end Short description When appointment is to conclude Definition Date/Time that the appointment is to conclude. Comments Note: This is intended for where precisely observed times are required, typically system logs etc., and not human-reported times - for them, see date and dateTime (which can be as precise as instant, but is not required to be) below. Time zone is always required Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.done[x] v2: SCH-11.5 / TQ1-8/ calculated based on the start and the duration which is in ARQ-9 rim: .effectiveTime.high ical: DTEND
minutesDuration		0..1	positiveInt	There are no (further) constraints on this element Element id Appointment.minutesDuration Short description 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. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] rim: .activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')].width ical: DURATION (e.g. PT15M)
slot	I	0..*	Reference(Slot)	There are no (further) constraints on this element Element id Appointment.slot Short description The slots that this appointment is filling Definition The slots from the participants' schedules that will be filled by the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Slot) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .outboundRelationship[@typeCode = 'REFR'].act[@classCode = 'ACT'][@moodCode = 'SLOT']
created	S	0..1	dateTime	There are no (further) constraints on this element Element id Appointment.created Short description 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. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.authoredOn rim: .author.time ical: CREATED
comment	S	0..1	string	There are no (further) constraints on this element Element id Appointment.comment Short description Additional comments Definition Additional comments about the appointment. 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.note v2: NTE-3 rim: .subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value ical: DESCRIPTION (for internal use)
patientInstruction	S	0..1	string	There are no (further) constraints on this element Element id Appointment.patientInstruction Short description Detailed information and instructions for the patient 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). Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: NTE-3 rim: .subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value ical: DESCRIPTION (for patient use)
basedOn	I	0..*	Reference(ServiceRequest)	Element id Appointment.basedOn Short description The service request this appointment is allocated to assess Alternate names incomingReferral Definition The service request this appointment is allocated to assess (e.g. incoming referral or procedure request). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(ServiceRequest) Allowed aggregation: referenced Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.basedOn rim: .outboundRelationship[@typeCode = 'FLFS'].act[@classCode < 'ActCareProvisionRequestType'][@moodCode = 'RQO']
participant	S I	1..*	BackboneElement	There are no (further) constraints on this element Element id Appointment.participant Short description Participants involved in appointment Definition List of participants involved in the appointment. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` app-1: Either the type or actor on the participant SHALL be specified `type.exists() or actor.exists()` Mappings rim: n/a workflow: Request.performer, Request.subject v2: PID, AIP, AIG, AIL rim: performer \| reusableDevice \| subject \| location ical: ATTENDEE component to be created
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
type	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.participant.type Short description Role of participant in the appointment Definition 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. Data type CodeableConcept Binding Role of participant in encounter. ParticipantType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: AIP-4, AIG-4 rim: (performer \| reusableDevice \| subject \| location).@typeCode ical: n/a
actor	S Σ I	0..1	Reference(Patient \| PractitionerRole \| Location)	Element id Appointment.participant.actor Short description Person, Location/HealthcareService or Device Definition A Person, Location/HealthcareService or Device that is participating in the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient \| PractitionerRole \| Location) Allowed aggregation: referenced Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) 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"
required	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant.required Short description required \| optional \| information-only 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Is the Participant required to attend the appointment. ParticipantRequired (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: (performer \| reusableDevice \| subject \| location).@performInd ical: ROLE=REQ-PARTICIPANT (roleparam)
status	S Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant.status Short description accepted \| declined \| tentative \| needs-action Definition Participation status of the actor. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The Participation status of an appointment. ParticipationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: AIP-12, AIG-14 rim: (performer \| reusableDevice \| subject \| location).statusCode ical: ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam \| partstatparam)
period	I	0..1	Period	There are no (further) constraints on this element Element id Appointment.participant.period Short description Participation period of the actor Definition Participation period of the actor. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
requestedPeriod	I	0..*	Period	There are no (further) constraints on this element Element id Appointment.requestedPeriod Short description 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. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] workflow: Request.occurrence[x] v2: ARQ-11 rim: .activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')]
text	S			There are no (further) constraints on this element Element id Appointment.text

Appointment		..
Appointment.meta		..
Appointment.extension	Extension	..
Appointment.text		..
Appointment.status		..
Appointment.description		..
Appointment.start		..
Appointment.end		..
Appointment.created		..
Appointment.comment		..
Appointment.patientInstruction		..
Appointment.basedOn	Reference(ServiceRequest)	..
Appointment.participant		..
Appointment.participant.actor	Reference(Patient \| PractitionerRole \| Location)	..
Appointment.participant.status		..

{
    "resourceType": "StructureDefinition",
    "id": "CA-eReC-Appointment",
    "url": "https://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Appointment",
    "version": "0.1.0",
    "name": "Appointment",
    "status": "draft",
    "description": "The resource involves booking one (or a series) of appointment(s) between the patient and the practitioner(s) for a specific date/time. The encounter may be a scheduled referral or an econsult.",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "Appointment",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Appointment",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "Appointment.meta",
                "path": "Appointment.meta",
                "comment": "The MustSupport flag on this element has been relaxed in this version until further confirmation of the use of meta.profile (outside of use for certain validation suites) and impact can be assessed by the working group."
            },
            {
                "id": "Appointment.extension:virtualService",
                "path": "Appointment.extension",
                "sliceName": "virtualService",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "http://hl7.org/fhir/5.0/StructureDefinition/extension-Appointment.virtualService"
                        ]
                    }
                ]
            },
            {
                "id": "Appointment.text",
                "path": "Appointment.text",
                "mustSupport": true
            },
            {
                "id": "Appointment.status",
                "path": "Appointment.status",
                "mustSupport": true
            },
            {
                "id": "Appointment.description",
                "path": "Appointment.description",
                "mustSupport": true
            },
            {
                "id": "Appointment.start",
                "path": "Appointment.start",
                "mustSupport": true
            },
            {
                "id": "Appointment.end",
                "path": "Appointment.end",
                "mustSupport": true
            },
            {
                "id": "Appointment.created",
                "path": "Appointment.created",
                "mustSupport": true
            },
            {
                "id": "Appointment.comment",
                "path": "Appointment.comment",
                "mustSupport": true
            },
            {
                "id": "Appointment.patientInstruction",
                "path": "Appointment.patientInstruction",
                "mustSupport": true
            },
            {
                "id": "Appointment.basedOn",
                "path": "Appointment.basedOn",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ServiceRequest"
                        ],
                        "aggregation":  [
                            "referenced"
                        ]
                    }
                ]
            },
            {
                "id": "Appointment.participant",
                "path": "Appointment.participant",
                "mustSupport": true
            },
            {
                "id": "Appointment.participant.actor",
                "path": "Appointment.participant.actor",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Patient",
                            "https://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-PractitionerRole",
                            "https://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Location"
                        ],
                        "aggregation":  [
                            "referenced"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "Appointment.participant.status",
                "path": "Appointment.participant.status",
                "mustSupport": true
            }
        ]
    }
}

Usage

The Appointment resource is used to represent a meeting planned in response to a ServiceRequest. References to other resources are used to convey the details of the appointment including ServiceRequest the appointment is based on (Appointment.basedOn) and participants (Appointment.participant.actor) in the appointment such as a Patient, PractitionerRole, or HealthcareService. Systems SHALL support start and SHALL support one of end or minutesDuration or both.

Notes

.id

used to uniquely identify the resource
if a persistent identity for the resource is not available to use when constructing a message Bundle for transmission via Direct Messaging, a UUID SHOULD be used in this element (with a corresponding value in Bundle.entry.fullUrl)

.text

used to provide human readable human readable that can be pasted into other systems with complete information about the appointment
where populated:
- .text.div SHALL include a full text summary of the appointment
- .text.status, populate with the fixed code "generated"

.status

typically populated with "booked" (or "cancelled" if unbooked)

.description

title of the appointment (e.g. the Subject on an appointment in MS Outlook)

.start

populate with the appointment start time
format: YYYY-MM-DDThh:mm:ss.sss+zz:zz (e.g. 2015-02-07T13:28:17.239+02:00 or 2017-01-01T00:00:00Z).

.end

populate with the appointment end time
format: YYYY-MM-DDThh:mm:ss.sss+zz:zz (e.g. 2015-02-07T13:28:17.239+02:00 or 2017-01-01T00:00:00Z).

.minutesDuration

duration of appointment in minutes
populate with a positive integer

.created

populate with the date that this appointment was initially created (NOT the time of the appointment itself)

.comment

additional comments and details about the appointment (i.e. the Body of an appointment in MS Outlook)

.patientInstruction

detailed information and instructions for the patient

.basedOn

associates the Appointment with the ServiceRequest being performed
SHALL be populated with a reference to the ServiceRequest being performed
if the Appointment is being transmitted via messaging, the referenced ServiceRequest resource SHALL be included in the message as a Bundle.entry

.participant

repeating element identifies one or more participants in the appointment where
- .participant.type is a value from ParticipantType(extensible)
- .participant.actor a reference to one of:
  - the Patient being seen > SHALL be the same as the ServiceRequest.subject
  - the HealthcareService providing the appointment > SHALL be same as the ServiceRequest.performer if both are present
  - the PractitionerRole seeing the patient
  - the Location of the appointment
- .participant.status is expected to be "accepted" for a booked appointment
Note:
- if an Appointment is being transmitted via messaging, referenced Patient, PractitionerRole and Location resources SHALL be included in the message as a Bundle.entry
- HealthcareService SHOULD typically be an external reference