Argo-Scheduling Implementation Guide Release 1.0.0

This page is part of the Argonaut Scheduling Implementation Guide (v1.0.0: Release) based on FHIR R3. This is the current published version. For a full list of available versions, see the Directory of published versions

Definitions for the StructureDefinition-argo-appt 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).

Control0..*
InvariantsDefined 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-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (: contained.text.empty())
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 (: contained.where(('#'+id in %resource.descendants().reference).not()).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())
Appointment.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
Must Supporttrue
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 may not always be associated with version changes to the resource.

Control0..1
TypeMeta
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.

Control0..1
Typeuri
Is Modifiertrue
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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Appointment.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from Common Languages; other codes may be used where these codes are not suitable
Typecode
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 may 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.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, 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 in formation 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.

Control0..*
TypeResource
Alternate Namesinline 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.

Appointment.extension
Definition

An Extension

Control0..*
TypeExtension
Appointment.extension ([CanonicalType[http://fhir.org/guides/argonaut-scheduling/StructureDefinition/extension-status-reason]])
Definition

Captures the reason for the current state of the Appointment.

Control0..1 This element is affected by the following invariants: ele-1
Type (Extension Type: CodeableConcept)
Alternate NamesSuspended Reason, Cancelled Reason
Comments

This is generally only used for "exception" statuses such as not-done, suspended or cancelled. The reason for performing the event at all is captured in the reason element, not here.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() | (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. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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).

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
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.

Control1..1
BindingThe free/busy status of an appointment.
The codes SHALL be taken from AppointmentStatus
Typecode
Is Modifiertrue
Must Supporttrue
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 categorisation of the service that is to be performed during this appointment.

Control0..1
BindingFor example codes, see ServiceCategory
TypeCodeableConcept
Appointment.serviceType
Definition

The specific service that is to be performed during this appointment.

Control0..*
BindingThe codes SHALL be taken from Argonaut_Visit_Types; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Appointment.specialty
Definition

The specialty of a practitioner that would be required to perform the service requested in this appointment.

Control0..*
BindingThe codes SHALL be taken from Argonaut_Scheduling_Specialties; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Appointment.appointmentType
Definition

The style of appointment or patient that has been booked in the slot (not service type).

Control0..1
BindingThe codes SHALL be taken from Argonaut_Appointment_Types; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Alternate Names`
Appointment.reason
Definition

The reason that this appointment is being scheduled. This is more clinical than administrative.

Control0..*
BindingThe Reason for the appointment to take place.
The codes SHOULD be taken from Encounter Reason Codes
TypeCodeableConcept
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.

Control0..*
TypeReference(Condition | Procedure)
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).

Control0..1
TypeunsignedInt
Comments

Seeking implementer feedback on this property and how interoperable it is.

Using an extension to record a codeableconcept for named values may be tested at a future connectathon.

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.

Control0..1
Typestring
Appointment.supportingInformation
Definition

Additional information to support the appointment provided when making the appointment.

Control0..*
TypeReference(Resource)
Appointment.start
Definition

Date/Time that the appointment is to take place.

Control1..1
Typeinstant
Must Supporttrue
Appointment.end
Definition

Date/Time that the appointment is to conclude.

Control1..1
Typeinstant
Must Supporttrue
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 (where actual time of appointment is only an estimate or is a planned appointment request).

Control0..1
TypepositiveInt
Appointment.slot
Definition

The slots from the participants' schedules that will be filled by the appointment.

Control0..*
TypeReference(Slot)
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.

Control0..1
TypedateTime
Comments

This property is required for many use cases where the age of an appointment is considered in processing workflows for scheduling and billing of appointments.

Appointment.comment
Definition

Additional comments about the appointment.

Control0..1
Typestring
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.incomingReferral
Definition

The referral request this appointment is allocated to assess (incoming referral).

Control0..*
TypeReference(ReferralRequest)
Appointment.participant(p-1)
Definition

List of participants involved in the appointment.

Control1..*
TypeBackboneElement
Must Supporttrue
InvariantsDefined 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() | (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.

Control0..1
Typestring
Appointment.participant.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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.

Control0..*
TypeExtension
Alternate Namesextensions, 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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, 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.

Control0..*
BindingRole of participant in encounter.
The codes SHALL be taken from ParticipantType; other codes may be used where these codes are not suitable
TypeCodeableConcept
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.

Control1..1
TypeReference(US Core Location Profile | US Core Patient Profile | US Core Practitioner Profile | HealthcareService)
Must Supporttrue
Appointment.participant.required
Definition

Is this participant required to be present at the meeting. This covers a use-case where 2 doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present.

Control0..1
BindingIs the Participant required to attend the appointment.
The codes SHALL be taken from ParticipantRequired
Typecode
Appointment.participant.status
Definition

Participation status of the actor.

Control1..1
BindingThe Participation status of an appointment.
The codes SHALL be taken from ParticipationStatus
Typecode
Must Supporttrue
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 minutes duration should be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time.

Control1..1
TypePeriod
Must Supporttrue
Comments

This does not introduce a capacity for recurring appointments.