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: http://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 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 | 0..1 | 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. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idAppointment.meta Metadata about the resource DefinitionThe 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.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idAppointment.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.language Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
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text | S | 0..1 | Narrative | There are no (further) constraints on this element Element idAppointment.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idAppointment.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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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 | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element 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. 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.
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cancelationReason | 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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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 | 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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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.
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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 | There are no (further) constraints on this element 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. 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 | Σ | 0..1 | instant | Element idAppointment.end When appointment is to conclude DefinitionDate/Time that the appointment is to conclude. 𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported.
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minutesDuration | 0..1 | positiveInt | 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. 𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported.
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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 | There are no (further) constraints on this element 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. 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 | S | 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 | 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). If systems are capturing instructions to a patient independently from other comments, they SHOULD use the patientInstruction field.
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basedOn | S I | 1..1 | Reference(ServiceRequest) | 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. Allowed aggregation: referenced Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.basedOn.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idAppointment.basedOn.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idAppointment.basedOn.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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participant | S 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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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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type | S 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.
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actor | S Σ I | 0..1 | Reference(Patient | PractitionerRole | Location) | 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 | PractitionerRole | Location) Allowed aggregation: referenced Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.actor.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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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.
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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.
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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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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 | 0..1 | 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. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idAppointment.meta Metadata about the resource DefinitionThe 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.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idAppointment.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.language Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
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text | S | 0..1 | Narrative | There are no (further) constraints on this element Element idAppointment.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idAppointment.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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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 | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element 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. 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.
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cancelationReason | 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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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 | 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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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.
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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 | There are no (further) constraints on this element 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. 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 | Σ | 0..1 | instant | Element idAppointment.end When appointment is to conclude DefinitionDate/Time that the appointment is to conclude. 𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported.
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minutesDuration | 0..1 | positiveInt | 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. 𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported.
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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 | There are no (further) constraints on this element 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. 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 | S | 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 | 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). If systems are capturing instructions to a patient independently from other comments, they SHOULD use the patientInstruction field.
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basedOn | S I | 1..1 | Reference(ServiceRequest) | 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. Allowed aggregation: referenced Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.basedOn.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idAppointment.basedOn.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idAppointment.basedOn.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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participant | S 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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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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type | S 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.
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actor | S Σ I | 0..1 | Reference(Patient | PractitionerRole | Location) | 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 | PractitionerRole | Location) Allowed aggregation: referenced Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.actor.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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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.
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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.
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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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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 | 0..1 | 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. |
meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idAppointment.meta Metadata about the resource DefinitionThe 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.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idAppointment.implicitRules A set of rules under which this content was created DefinitionA 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. 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.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.language Language of the resource content DefinitionThe base language in which the resource is written. 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). A human language.
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text | S | 0..1 | Narrative | There are no (further) constraints on this element Element idAppointment.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA 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. 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.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idAppointment.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese 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. 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.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay 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). 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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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 | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element 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. 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.
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cancelationReason | 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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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 | 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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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.
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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 | There are no (further) constraints on this element 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. 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 | Σ | 0..1 | instant | Element idAppointment.end When appointment is to conclude DefinitionDate/Time that the appointment is to conclude. 𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported.
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minutesDuration | 0..1 | positiveInt | 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. 𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported.
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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 | There are no (further) constraints on this element 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. 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 | S | 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 | 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). If systems are capturing instructions to a patient independently from other comments, they SHOULD use the patientInstruction field.
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basedOn | S I | 1..1 | Reference(ServiceRequest) | 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. Allowed aggregation: referenced Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.basedOn.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idAppointment.basedOn.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idAppointment.basedOn.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | S Σ | 0..1 | uri | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idAppointment.basedOn.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.basedOn.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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participant | S 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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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.modifierExtension Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay 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). 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. 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.
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type | S 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.
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actor | S Σ I | 0..1 | Reference(Patient | PractitionerRole | Location) | 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 | PractitionerRole | Location) Allowed aggregation: referenced Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.actor.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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reference | S Σ I | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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type | Σ | 0..1 | uriBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.type Type the reference refers to (e.g. "Patient") DefinitionThe expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. Aa resource (or, for logical models, the URI of the logical model).
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identifier | S Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
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id | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.id Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.extension Additional content defined by implementations Alternate namesextensions, user content DefinitionMay 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. 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. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.use usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known .
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type | Σ | 0..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.type Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. 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. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.system The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. 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. Identifier.system is always case sensitive.
General http://www.acme.com/identifiers/patient Mappings
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value | S Σ | 1..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.value The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
General 123456 Mappings
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period | Σ I | 0..1 | Period | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.period Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. 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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assigner | Σ I | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idAppointment.participant.actor.identifier.assigner Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. 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.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAppointment.participant.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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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.
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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.
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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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Appointment | .. | |
Appointment.text | .. | |
Appointment.status | .. | |
Appointment.description | .. | |
Appointment.start | .. | |
Appointment.end | .. | |
Appointment.minutesDuration | .. | |
Appointment.created | .. | |
Appointment.comment | .. | |
Appointment.patientInstruction | .. | |
Appointment.basedOn | Reference(ServiceRequest) | 1..1 |
Appointment.basedOn.reference | .. | |
Appointment.basedOn.identifier | .. | |
Appointment.basedOn.identifier.system | .. | |
Appointment.basedOn.identifier.value | .. | |
Appointment.participant | .. | |
Appointment.participant.type | .. | |
Appointment.participant.actor | Reference(Patient | PractitionerRole | Location) | .. |
Appointment.participant.actor.reference | .. | |
Appointment.participant.actor.identifier | .. | |
Appointment.participant.actor.identifier.system | 1.. | |
Appointment.participant.actor.identifier.value | 1.. |
{ "resourceType": "StructureDefinition", "id": "CA-eReC-Appointment", "url": "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Appointment", "version": "1.0.0", "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.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", "comment": "𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported." }, { "id": "Appointment.minutesDuration", "path": "Appointment.minutesDuration", "comment": "𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported." }, { "id": "Appointment.created", "path": "Appointment.created", "mustSupport": true }, { "id": "Appointment.comment", "path": "Appointment.comment", "mustSupport": true }, { "id": "Appointment.patientInstruction", "path": "Appointment.patientInstruction", "comment": "If systems are capturing instructions to a patient independently from other comments, they SHOULD use the patientInstruction field." }, { "id": "Appointment.basedOn", "path": "Appointment.basedOn", "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": [ "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-ServiceRequest" ], "aggregation": [ "referenced" ] } ], "mustSupport": true }, { "id": "Appointment.basedOn.reference", "path": "Appointment.basedOn.reference", "mustSupport": true }, { "id": "Appointment.basedOn.identifier", "path": "Appointment.basedOn.identifier", "mustSupport": true }, { "id": "Appointment.basedOn.identifier.system", "path": "Appointment.basedOn.identifier.system", "mustSupport": true }, { "id": "Appointment.basedOn.identifier.value", "path": "Appointment.basedOn.identifier.value", "mustSupport": true }, { "id": "Appointment.participant", "path": "Appointment.participant", "mustSupport": true }, { "id": "Appointment.participant.type", "path": "Appointment.participant.type", "mustSupport": true }, { "id": "Appointment.participant.actor", "path": "Appointment.participant.actor", "type": [ { "code": "Reference", "targetProfile": [ "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Patient", "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-PractitionerRole", "http://fhir.infoway-inforoute.ca/io/CA-eReC/StructureDefinition/CA-eReC-Location" ], "aggregation": [ "referenced" ] } ], "mustSupport": true }, { "id": "Appointment.participant.actor.reference", "path": "Appointment.participant.actor.reference", "mustSupport": true }, { "id": "Appointment.participant.actor.identifier", "path": "Appointment.participant.actor.identifier", "mustSupport": true }, { "id": "Appointment.participant.actor.identifier.system", "path": "Appointment.participant.actor.identifier.system", "min": 1, "mustSupport": true }, { "id": "Appointment.participant.actor.identifier.value", "path": "Appointment.participant.actor.identifier.value", "min": 1, "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"
.identifier
- MAY be populated to share business identifers used to reference this resource in subsequent messages
identifier.system
andidentifier.value
SHALL be mustSupport whenever there is a reference or identifier present
.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
- 𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported
- 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
- 𝗦𝗨𝗣𝗣𝗢𝗥𝗧: One of end or minutesDuration must be supported
- 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
- If systems are capturing instructions to a patient independently from other comments, they SHOULD use the patientInstruction field.
.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, this element SHALL either:
.reference
a resource included in the message as aBundle.entry
, or- include an
.identifier
previously known to both systems
.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 PractitionerRole seeing the patient
- the Location of the appointment
- the Patient being seen > SHALL be the same as the
.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 either:
.reference
a resource included in the message as aBundle.entry
- include an
.identifier
previously known to both systems