TELUS DW Generic FHIR Extract

There are no (further) constraints on this element

Element id

Appointment.meta.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Appointment.meta.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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

versionId

0..1

There are no (further) constraints on this element

Element id

Appointment.meta.versionId

Short description

Version specific identifier

Definition

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

lastUpdated

0..1

Element id

Appointment.meta.lastUpdated

Short description

When the resource version last changed

Definition

When the resource last changed - e.g. when the version changed.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🔴 Not Supported

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

source

0..1

Element id

Appointment.meta.source

Short description

Identifies where the resource comes from

Definition

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🔴 Not Supported
PSS: 🟢 populate-if-known

Data type

canonical(StructureDefinition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

profile

0..*

There are no (further) constraints on this element

Element id

Appointment.meta.profile

Short description

Profiles this resource claims to conform to

Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Data type

canonical(StructureDefinition)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a

security

0..*

CodingBinding

Element id

Appointment.meta.security

Short description

Security Labels applied to this resource

Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Populated when the patient record is restricted.

Data type

Coding

Binding

Security Labels from the Healthcare Privacy and Security Classification System.

All Security Labels (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

tag

0..*

Coding

There are no (further) constraints on this element

Element id

Appointment.meta.tag

Short description

Tags applied to this resource

Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Data type

Coding

Binding

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

CommonTags (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 subset one of the sets of component 1-3 or 4-6
rim: CV
orim: fhir:Coding rdfs:subClassOf dt:CDCoding

implicitRules

Σ ?!

0..1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..*

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

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

appointmentEMRCustomStatus

S C

0..*

Element id

Appointment.extension:appointmentEMRCustomStatus

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Provides the EMR-specific appointment status value as a string. CHR uses system-defined values (e.g., booked, cancelled, arrived). MA uses a clinic-configured appointment status value. PSS uses a clinic-configurable custom status.

Data type

AppointmentEMRCustomStatus

Extension URL

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

virtualVisit

S C

0..*

Extension(boolean)

Element id

Appointment.extension:virtualVisit

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Boolean indicating whether the appointment is a virtual visit. CHR: true when visit_type = virtual_visit; omitted when null. MA: true when the virtual visit indicator is set. PSS: true for telephone or video visit types.

Data type

Extension(boolean)

Extension URL

VirtualVisit

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

virtualVisitType

S C

0..*

Element id

Appointment.extension:virtualVisitType

Short description

Optional Extensions Element

Alternate names

extensions, user content

Definition

Optional Extension Element - found in all resources.

Comments

EMR Support:

CHR: 🔴 Not Supported
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Provides the type of virtual appointment. MA: virtual visit type (e.g., Phone, Video). PSS: medium value (Telephone Call or Virtual Visit Video).

Data type

Extension URL

VirtualVisitType

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

?! C

0..*

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

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..*

Identifier

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).

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Data type

Identifier

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

There are no (further) constraints on this element

Element id

Appointment.identifier.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

Mappings

rim: n/a

extension

0..*

There are no (further) constraints on this element

Element id

Appointment.identifier.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

use

Σ ?!

0..1

codeBinding

There are no (further) constraints on this element

Element id

Appointment.identifier.use

Short description

usual | official | temp | secondary | old (If known)

Definition

The purpose of this identifier.

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Data type

Binding

Identifies the purpose for this identifier, if known .

IdentifierUse (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: n/a
v2: N/A
rim: Role.code or implied by context

type

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Appointment.identifier.type

Short description

Description of identifier

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Data type

Identifier Type Codes (extensible)

Binding

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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: CX.5
rim: Role.code or implied by context

system

0..1

Element id

Appointment.identifier.system

Short description

The namespace for the identifier value

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Pattern: urn:telus:emr:{emrtype}:{emrinstance}:appointment

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

http://www.acme.com/identifiers/patient

Mappings

rim: n/a
v2: CX.4 / EI-2-4
rim: II.root or Role.id.root
servd: ./IdentifierType

value

0..1

Element id

Appointment.identifier.value

Short description

The value that is unique

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Examples
General

Mappings

rim: n/a
v2: CX.1 / EI.1
rim: II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
servd: ./Value

period

Σ C

0..1

There are no (further) constraints on this element

Element id

Appointment.identifier.period

Short description

Time period when id is/was valid for use

Definition

Time period during which identifier is/was valid for use.

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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"]
v2: CX.7 + CX.8
rim: Role.effectiveTime or implied by context
servd: ./StartDate and ./EndDate

assigner

Σ C

0..1

Reference(Organization)

There are no (further) constraints on this element

Element id

Appointment.identifier.assigner

Short description

Organization that issued id (may be just text)

Definition

Organization that issued/manages the identifier.

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Data type

Reference(Organization)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

Mappings

rim: n/a
rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
v2: CX.4 / (CX.4,CX.9,CX.10)
rim: II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
servd: ./IdentifierIssuingAuthority

status

S Σ ?!

1..1

codeBinding

Element id

Appointment.status

Short description

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

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

MA → FHIR mapping: contains 'booked' or 'Confirmed' → booked | contains 'arrived', 'Waiting in Room' or 'Seeing Doctor' → arrived | contains 'done' or 'Seen Off Site' → fulfilled | contains 'cancel' or 'rebooked' → cancelled | contains 'no show' → noshow | contains 'entered-in-error' or 'Deleted' → entered-in-error | contains 'checked in' or 'checked-in' → checked-in | contains 'wait list' or 'waitlist' → waitlist | starts with 'request' → pending | otherwise → proposed.

PSS → FHIR mapping: no_show → noshow | deleted → cancelled | cancelled → cancelled | left without being seen (lwbs) → noshow | otherwise → booked.

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

Data type

Binding

The free/busy status of an appointment.

AppointmentStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

S Σ

0..1

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

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Provide cancellation reason where available. CHR: not available as a structured field. MA: may be derived from the note field when the appointment status is Cancelled. PSS: reason is documented in the details field in parentheses after the appointment is cancelled.

Data type

AppointmentCancellationReason (example)

Binding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..*

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

Binding

ServiceCategory (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..*

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

Binding

ServiceType (example)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

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

Data type

PracticeSettingCodeValueSet (preferred)

Binding

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

S Σ

0..1

CodeableConceptBinding

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

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: Service name from the appointment's service. MA: Appointment type value; 'Group Session' when a group is associated. PSS: Appointment type name.

Data type

Binding

v2.0276 (preferred)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

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

Data type

EncounterReasonCodes (preferred)

Binding

The Reason for the appointment to take place.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..*

Reference(Condition | ImmunizationRecommendation | Observation | Procedure)

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 | ImmunizationRecommendation | Observation | Procedure)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

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

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

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

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: Presenting issue field. MA: Concern field. PSS: Details field.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

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

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

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

Element id

Appointment.start

Short description

When appointment is to take place

Definition

Date/Time that the appointment is to take place.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Format: YYYY-MM-DDThh:mm:ss.sss+zz:zz. If FHIR status is not proposed or cancelled, start must be present; provide data-absent-reason of unknown if missing.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

Element id

Appointment.end

Short description

When appointment is to conclude

Definition

Date/Time that the appointment is to conclude.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Format: YYYY-MM-DDThh:mm:ss.sss+zz:zz. If FHIR status is not proposed or cancelled, end must be present; provide data-absent-reason of unknown if missing. PSS does not have an end dateTime field; calculate from start + minutesDuration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

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

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

CHR: Slot length. MA: Calculated from start and end time; omit if either is null or duration = 0. PSS: Appointment duration.

Data type

positiveInt

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

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

Data type

Reference(Slot)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

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

0..1

dateTime

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

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Date and time the appointment booking was created. CHR: Appointment creation date. MA: Booking date. PSS: Booking date (can be NULL).

Data type

dateTime

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

Element id

Appointment.comment

Short description

Additional comments

Definition

Additional comments about the appointment.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

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

Reference(DwServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

S C

0..*

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

EMR Support:

CHR: 🟢 populate-if-known
MA: 🔴 Not Supported
PSS: 🔴 Not Supported

CHR: When the appointment is the result of an internal or external referral, provide the reference to the ServiceRequest.

Data type

Reference(DwServiceRequest)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

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 C

1..*

BackboneElement

Element id

Appointment.participant

Short description

Participants involved in appointment

Definition

List of participants involved in the appointment.

Comments

EMR Support:

CHR: 🟢 populate-if-known
MA: 🟢 populate-if-known
PSS: 🟢 populate-if-known

This is 1 to many. Includes patient and provider participants. participant.status is hard-coded to 'accepted' as participation status is not tracked by the EMR.

Data type

BackboneElement

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

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

Mappings

rim: n/a

extension

0..*

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

Comments

Data type

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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 ?! C

0..*

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

Comments

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

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

Binding

Role of participant in encounter.

ParticipantType (extensible)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

Σ C

0..1

Reference(DwHealthcareService | DwLocation | DwPatient | DwPractitioner | DwPractitionerRole)

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

Data type

Reference(DwHealthcareService | DwLocation | DwPatient | DwPractitioner | DwPractitionerRole)

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))

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

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

ParticipantRequired (required)

Binding

Is the Participant required to attend the appointment.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

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

ParticipationStatus (required)

Binding

The Participation status of an appointment.

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..1

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

Period is not used for a duration (a measure of elapsed time). See Duration.

Data type

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

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

0..*

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