This page is part of a downloaded copy of this specification. This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v0.1.0: STU 1 Ballot 1) based on FHIR v3.5.0. . For a full list of available versions, see the Directory of published versions

## StructureDefinition: CRD Appointment - Detailed Descriptions

Definitions for the profile-appointment-r4 Profile.

Appointment
Definition | A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s).
Control | 0..*
Invariants | Defined on this element app-2: Either start and end are specified, or neither (: start.empty() xor end.exists()) app-3: Only proposed or cancelled appointments can be missing start/end dates (: (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled'))) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (: text.div.exists())
Appointment.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control | 0..1
Type | id
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Appointment.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Control | 0..1
Type | Meta
Appointment.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Control | 0..1
Type | uri
Is Modifier | true
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Appointment.language
Definition | The base language in which the resource is written.
Control | 0..1
Binding | A human language. The codes SHOULD be taken from Common Languages
Type | code
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Appointment.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Control | 0..1
Type | Narrative
Alternate Names | narrative, html, xhtml, display
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Appointment.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Control | 0..*
Type | Resource
Alternate Names | inline resources, anonymous resources, contained resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Appointment.extension
Definition | An Extension
Control | 0..*
Type | Extension
Appointment.extension ([CanonicalType[http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-insurance]])
Definition | Indicates coverage relevant to the appointment.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | (Extension Type: Reference(CRD Coverage))
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Appointment.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. 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).
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Appointment.identifier
Definition | This records identifiers associated with this appointment concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
Note | This is a business identifer, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Must Support | true
Appointment.status
Definition | The overall status of the Appointment. Each of the participants has their own participation status which indicates their involvement in the process, however this status indicates the shared status.
Control | 1..1
Binding | The free/busy status of an appointment. The codes SHALL be taken from AppointmentStatus
Type | code
Is Modifier | true
Must Support | true
Comments | If the Appointment's status is "cancelled" then all participants are expected to have their calendars released for the appointment period, and as such any Slots that were marked as BUSY can be re-set to FREE. This element is labeled as a modifier because the status contains the code entered-in-error that mark the Appointment as not currently valid.
Appointment.serviceCategory
Definition | A broad categorization of the service that is to be performed during this appointment.
Control | 0..*
Binding | For example codes, see ServiceCategory
Type | CodeableConcept
Must Support | true
Appointment.serviceType
Definition | The specific service that is to be performed during this appointment.
Control | 0..*
Binding | For example codes, see ServiceType
Type | CodeableConcept
Must Support | true
Comments | For a provider to provider appointment the code "FOLLOWUP" may be appropriate, as this is expected to be discussing some patient that was seen in the past.
Appointment.specialty
Definition | The specialty of a practitioner that would be required to perform the service requested in this appointment.
Control | 0..*
Binding | The codes SHOULD be taken from PracticeSettingCodeValueSet
Type | CodeableConcept
Must Support | true
Appointment.appointmentType
Definition | The style of appointment or patient that has been booked in the slot (not service type).
Control | 0..1
Binding | The codes SHOULD be taken from http://terminology.hl7.org/ValueSet/v2-0276
Type | CodeableConcept
Must Support | true
Appointment.reason
Definition | The reason that this appointment is being scheduled. This is more clinical than administrative.
Control | 0..*
Binding | The Reason for the appointment to take place. The codes SHOULD be taken from EncounterReasonCodes
Type | CodeableConcept
Comments | potentially relevant for CRD in some situations.
Appointment.indication
Definition | Reason the appointment has been scheduled to take place, as specified using information from another resource. When the patient arrives and the encounter begins it may be used as the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.
Control | 0..*
Type | Reference(CRD Condition | Procedure)
Must Support | true
Comments | potentially relevant for CRD in some situations.
Appointment.priority
Definition | The priority of the appointment. Can be used to make informed decisions if needing to re-prioritize appointments. (The iCal Standard specifies 0 as undefined, 1 as highest, 9 as lowest priority).
Control | 0..1
Type | unsignedInt
Comments | potentially relevant for CRD in some situations.
Appointment.description
Definition | The brief description of the appointment as would be shown on a subject line in a meeting request, or appointment list. Detailed or expanded information should be put in the comment field.
Control | 0..1
Type | string
Appointment.supportingInformation
Definition | Additional information to support the appointment provided when making the appointment.
Control | 0..*
Type | Reference(Resource)
Comments | potentially relevant for CRD in some situations.
Appointment.start
Definition | Date/Time that the appointment is to take place.
Control | 1..1
Type | instant
Must Support | true
Appointment.end
Definition | Date/Time that the appointment is to conclude.
Control | 1..1
Type | instant
Must Support | true
Appointment.minutesDuration
Definition | Number of minutes that the appointment is to take. This can be less than the duration between the start and end times. For example, where the actual time of appointment is only an estimate or if a 30 minute appointment is being requested, but any time would work. Also, if there is, for example, a planned 15 minute break in the middle of a long appointment, the duration may be 15 minutes less than the difference between the start and end.
Control | 0..1
Type | positiveInt
Appointment.slot
Definition | The slots from the participants' schedules that will be filled by the appointment.
Control | 0..*
Type | Reference(Slot)
Comments | potentially relevant for CRD in some situations.
Appointment.created
Definition | The date that this appointment was initially created. This could be different to the meta.lastModified value on the initial entry, as this could have been before the resource was created on the FHIR server, and should remain unchanged over the lifespan of the appointment.
Control | 0..1
Type | dateTime
Comments | potentially relevant for CRD in some situations.
Appointment.comment
Definition | Additional comments about the appointment.
Control | 0..1
Type | string
Comments | Additional text to aid in facilitating the appointment. For instance, a comment might be, "patient should proceed immediately to infusion room upon arrival" Where this is a planned appointment and the start/end dates are not set then this field can be used to provide additional guidance on the details of the appointment request, including any restrictions on when to book it.
Appointment.patientInstruction
Definition | While Appointment.comment contains information for internal use, Appointment.patientInstructions is used to capture patient facing information about the Appointment (e.g. please bring your referral or fast from 8pm night before).
Control | 0..1
Type | string
Appointment.basedOn
Definition | The service request this appointment is allocated to assess (e.g. incoming referral or procedure request).
Control | 0..*
Type | Reference(CRD ServiceRequest)
Alternate Names | incomingReferral
Comments | potentially relevant for CRD in some situations.
Appointment.participant
Definition | List of participants involved in the appointment.
Control | 1..*
Type | BackboneElement
Must Support | true
Invariants | Defined on this element app-1: Either the type or actor on the participant SHALL be specified (: type.exists() or actor.exists()) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Appointment.participant.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
Appointment.participant.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control | 0..*
Type | Extension
Alternate Names | extensions, user content
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Appointment.participant.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. 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).
Control | 0..*
Type | Extension
Is Modifier | true
Alternate Names | extensions, user content, modifiers
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Appointment.participant.type
Definition | Role of participant in the appointment.
Control | 0..*
Binding | Role of participant in encounter. The codes SHALL be taken from ParticipantType; other codes may be used where these codes are not suitable
Type | CodeableConcept
Comments | The role of the participant can be used to declare what the actor will be doing in the scope of this appointment. If the actor is not specified, then it is expected that the actor will be filled in at a later stage of planning. This value SHALL be the same when creating an AppointmentResponse so that they can be matched, and subsequently update the Appointment.
Appointment.participant.actor
Definition | A Person, Location/HealthcareService or Device that is participating in the appointment.
Control | 0..1
Type | Reference(CRD Patient | CRD Practitioner | CRD Location)
Must Support | true
Appointment.participant.required
Definition | Whether this participant is required to be present at the meeting. This covers a use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.
Control | 0..1
Binding | Is the Participant required to attend the appointment. The codes SHALL be taken from ParticipantRequired
Type | code
Appointment.participant.status
Definition | Participation status of the actor.
Control | 1..1
Binding | The Participation status of an appointment. The codes SHALL be taken from ParticipationStatus
Type | code
Must Support | true
Appointment.participant.period
Definition | Participation period of the actor.
Control | 0..1
Type | Period
Appointment.requestedPeriod
Definition | A set of date ranges (potentially including times) that the appointment is preferred to be scheduled within. When using these values, the duration (usually in minutes) should be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time.
Control | 1..1
Type | Period
Must Support | true
Comments | This does not introduce a capacity for recurring appointments.