DwAppointment
Purpose
The purpose of this resource to provide booking of a healthcare event among patient(s), practitioner(s), and/or device(s) for a specific date/time. This may result in one or more Encounter(s).
Appointment | I | Appointment | There are no (further) constraints on this element Element IdAppointment 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) DefinitionA 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).
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id | Σ | 1..1 | System.String | There are no (further) constraints on this element Element IdAppointment.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. System.String |
identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element IdAppointment.identifier External Ids for this item DefinitionThis 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).
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status | Σ ?! | 1..1 | codeBinding | Element IdAppointment.status proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist DefinitionThe 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. MA Booked --> Booked Checked In --> Arrived Waiting in Room --> Arrived Seeing Doctor --> Arrived Done --> fulfilled No Show -->noshow Cancelled --> cancelled Template -->? Rebooked --> Confirm how users use this Pending --> pending (confirm whether this is default status) Seen Off Site-->? Unfilled --> ? Request --> Pending Deleted --> enterted-in-error Email Reminder Sent --> Booked Confirmed --> Booked PSS --> FHIR No status --> Booked Confirmed --> Booked Arrived --> Arrived In room -- Arrived Ready --> Arrived Finished -->fulfilled appt.no show -->noshow appt.deleted-->entered-in-error appt.cancelled --> cancelled appt.lwbs --> noshow NA for data services - If the Appointment's status is "cancelled" then all participants are expected to have their calendars released for the appointment period, and as such any Slots that were marked as BUSY can be re-set to FREE. This element is labeled as a modifier because the status contains the code entered-in-error that mark the Appointment as not currently valid. The free/busy status of an appointment. AppointmentStatus (required)Constraints
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cancelationReason | S Σ | 0..1 | CodeableConcept | There are no (further) constraints on this element Element IdAppointment.cancelationReason The coded reason for the appointment being cancelled DefinitionThe 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. 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. AppointmentCancellationReason (example) Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdAppointment.cancelationReason.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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text | Σ | 0..1 | string | Element IdAppointment.cancelationReason.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Provide cancellation reason where available PSS - Reason is documented in details field in paranthesis after the appointment is cancelled. Provide full text Very often the text is the same as a displayName of one of the codings.
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serviceCategory | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdAppointment.serviceCategory A broad categorization of the service that is to be performed during this appointment DefinitionA broad categorization of the service that is to be performed during this appointment. 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.
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serviceType | Σ | 0..* | CodeableConcept | There are no (further) constraints on this element Element IdAppointment.serviceType The specific service that is to be performed during this appointment DefinitionThe specific service that is to be performed during this appointment. For a provider to provider appointment the code "FOLLOWUP" may be appropriate, as this is expected to be discussing some patient that was seen in the past.
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specialty | Σ | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdAppointment.specialty The specialty of a practitioner that would be required to perform the service requested in this appointment DefinitionThe specialty of a practitioner that would be required to perform the service requested in this appointment. 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. PracticeSettingCodeValueSet (preferred) Constraints
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appointmentType | S Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element IdAppointment.appointmentType The style of appointment or patient that has been booked in the slot (not service type) DefinitionThe style of appointment or patient that has been booked in the slot (not service type). 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.
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element IdAppointment.appointmentType.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for alternative encodings within a code system, and translations to other code systems. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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text | Σ | 0..1 | string | Element IdAppointment.appointmentType.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Provide text of the custom appt type created Very often the text is the same as a displayName of one of the codings.
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reasonCode | Σ | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdAppointment.reasonCode Coded reason this appointment is scheduled DefinitionThe coded reason that this appointment is being scheduled. This is more clinical than administrative. 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. The Reason for the appointment to take place. EncounterReasonCodes (preferred)Constraints
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reasonReference | I | 0..* | Reference(Condition | Procedure | Observation | ImmunizationRecommendation) | There are no (further) constraints on this element Element IdAppointment.reasonReference Reason the appointment is to take place (resource) DefinitionReason 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. 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. Reference(Condition | Procedure | Observation | ImmunizationRecommendation) Constraints
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priority | 0..1 | unsignedInt | There are no (further) constraints on this element Element IdAppointment.priority Used to make informed decisions if needing to re-prioritize DefinitionThe priority of the appointment. Can be used to make informed decisions if needing to re-prioritize appointments. (The iCal Standard specifies 0 as undefined, 1 as highest, 9 as lowest priority). Seeking implementer feedback on this property and how interoperable it is. Using an extension to record a CodeableConcept for named values may be tested at a future connectathon.
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description | S | 0..1 | string | Element IdAppointment.description Shown on a subject line in a meeting request, or appointment list DefinitionThe 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. MA - concern field PSS - details field Note that FHIR strings SHALL NOT exceed 1MB in size
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supportingInformation | I | 0..* | Reference(Resource) | There are no (further) constraints on this element Element IdAppointment.supportingInformation Additional information to support the appointment DefinitionAdditional information to support the appointment provided when making the appointment. 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.
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start | S Σ | 0..1 | instant | There are no (further) constraints on this element Element IdAppointment.start When appointment is to take place DefinitionDate/Time that the appointment is to take place. 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
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end | S Σ | 0..1 | instant | Element IdAppointment.end When appointment is to conclude DefinitionDate/Time that the appointment is to conclude. PSS - Does not have an end date MA - Provide the end date 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
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minutesDuration | S | 0..1 | positiveInt | There are no (further) constraints on this element Element IdAppointment.minutesDuration Can be less than start/end (e.g. estimate) DefinitionNumber 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. 32 bit number; for values larger than this, use decimal
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slot | I | 0..* | Reference(Slot) | There are no (further) constraints on this element Element IdAppointment.slot The slots that this appointment is filling DefinitionThe slots from the participants' schedules that will be filled by the appointment. 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.
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created | S | 0..1 | dateTime | Element IdAppointment.created The date that this appointment was initially created DefinitionThe 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. Date and time the appointment was booking was created 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.
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comment | 0..1 | string | There are no (further) constraints on this element Element IdAppointment.comment Additional comments DefinitionAdditional comments about the appointment. 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.
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patientInstruction | 0..1 | string | There are no (further) constraints on this element Element IdAppointment.patientInstruction Detailed information and instructions for the patient DefinitionWhile 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). Note that FHIR strings SHALL NOT exceed 1MB in size
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basedOn | I | 0..* | Reference(ServiceRequest) | There are no (further) constraints on this element Element IdAppointment.basedOn The service request this appointment is allocated to assess Alternate namesincomingReferral DefinitionThe service request this appointment is allocated to assess (e.g. incoming referral or procedure request). 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.
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participant | I | 1..* | BackboneElement | There are no (further) constraints on this element Element IdAppointment.participant Participants involved in appointment DefinitionList of participants involved in the appointment.
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type | Σ | 0..* | CodeableConceptBinding | There are no (further) constraints on this element Element IdAppointment.participant.type Role of participant in the appointment DefinitionRole of participant in the appointment. The role of the participant can be used to declare what the actor will be doing in the scope of this appointment. If the actor is not specified, then it is expected that the actor will be filled in at a later stage of planning. This value SHALL be the same when creating an AppointmentResponse so that they can be matched, and subsequently update the Appointment. Role of participant in encounter. ParticipantType (extensible)Constraints
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actor | Σ I | 0..1 | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location) | There are no (further) constraints on this element Element IdAppointment.participant.actor Person, Location/HealthcareService or Device DefinitionA Person, Location/HealthcareService or Device that is participating in the appointment. 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. Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location) Constraints
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required | Σ | 0..1 | codeBinding | There are no (further) constraints on this element Element IdAppointment.participant.required required | optional | information-only DefinitionWhether 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. Note that FHIR strings SHALL NOT exceed 1MB in size Is the Participant required to attend the appointment. ParticipantRequired (required)Constraints
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status | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element IdAppointment.participant.status accepted | declined | tentative | needs-action DefinitionParticipation status of the actor. Note that FHIR strings SHALL NOT exceed 1MB in size The Participation status of an appointment. ParticipationStatus (required)Constraints
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period | I | 0..1 | Period | There are no (further) constraints on this element Element IdAppointment.participant.period Participation period of the actor DefinitionParticipation period of the actor. 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.
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requestedPeriod | I | 0..* | Period | There are no (further) constraints on this element Element IdAppointment.requestedPeriod Potential date/time interval(s) requested to allocate the appointment within DefinitionA set of date ranges (potentially including times) that the appointment is preferred to be scheduled within. The duration (usually in minutes) could also be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time. However, in other situations the duration may be calculated by the scheduling system. This does not introduce a capacity for recurring appointments.
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Usage note
- Description - The reason patient reported for the appointment, typically documented in text.
Bundle
Example
{
"resourceType":"Appointment",
"id":"pss-CDK5-Appointment-1859860",
"meta":{
"source":"urn:telus:emr:pss:CDK5",
"lastUpdated":"2023-01-03T10:58:31.000Z",
"security":[{
"system":"http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
"code":"N",
"display":"normal"
}
]
},
"identifier":[{
"system":"urn:telus:emr:pss:CDK5:Appointment",
"use":"official",
"value":"1859860"
}
],
"status":"booked",
"appointmentType":{"text":"Female Physical"},
"priority":0,
"description":"- CPX",
"start":"2022-12-21T09:00:00.000Z",
"end": "2022-12-21T09:30:00.000Z",
"minutesDuration":30,
"created":"2022-12-21T21:35:53.000Z",
"participant":[{
"actor":{
"reference":"Patient/pss-CDK5-Patient-",
"type":"Patient"
},
"status":"accepted",
"required":"required",
"type":[{
"text":"Patient"
}
]
}, {
"actor":{
"reference":"Practitioner/pss-CDK5-Practitioner-15",
"display":"Dr. Hanna Hook",
"type":"Practitioner",
},
"status":"accepted",
"required":"required",
"type":[{
"text":"Practitioner",
}
]
}
]
}