R4 Ballot #1 #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.3.0: (v3.5.0: R4 Ballot 2). #2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

12.11 Resource AppointmentResponse - Content

Patient Administration Work Group Maturity Level : 3   Trial Use Compartments : Device , Patient , Practitioner , RelatedPerson

A reply to an appointment request for a patient and/or practitioner(s), such as a confirmation or rejection.

12.11.1 Scope and Usage

Appointment resources are used to provide information about a planned meeting that may be in the future or past. They may be for a single meeting or for a series of repeating visits. Examples include a scheduled surgery, a follow-up for a clinical visit, a scheduled conference call between clinicians to discuss a case, the reservation of a piece of diagnostic equipment for a particular use, etc. The visit scheduled by an appointment may be in person or remote (by phone, video conference, etc.). All that matters is that the time and usage of one or more individuals, locations and/or pieces of equipment is being fully or partially reserved for a designated period of time.

This definition takes the concepts of appointments in a clinical setting and also extends them to be relevant in the community healthcare space, and also ease exposure to other appointment / calendar standards widely used outside of Healthcare.

12.11.1.1 The basic workflow to create an appointment

  • Making the Appointment Request

    When an appointment is required, a requester creates new Appointment resource with the Appointment.status="proposed".
    All included participants (optional or mandatory) should have the status="needs-action" to allow filtering and displaying appointments to user-participants for accepting or rejecting new and updated requests. Based on internal system business rules, certain statuses may be automatically updated, for example: "reject because the requested participant is on vacation" or "this type of user is not allowed to request those specific appointments".

  • Replying to the request

    The reply process is simply performed by the person/system handing the requests updating the participant statuses as needed. If there are multiple systems involved, then these will create AppointmentResponse entries with the desired statuses.

    Once all participants have their participation status created/updated (and the main system marking the appointment participant records with the AppointmentResponse statuses) then the overall status of the Appointment is updated.

This resource is referenced by imagingstudy ImagingStudy

12.11.2 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . AppointmentResponse I TU DomainResource A reply to an appointment request for a patient and/or practitioner(s), such as a confirmation or rejection
+ Rule: Either the participantType or actor must be specified
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier External Ids for this item
. . . appointment Σ 1..1 Reference ( Appointment ) Appointment this response relates to
. . . start 0..1 instant Time from appointment, or requested new start time
. . . end 0..1 instant Time from appointment, or requested new end time
. . . participantType Σ 0..* CodeableConcept Role of participant in the appointment
ParticipantType Participant type ( Extensible )
. . . actor Σ 0..1 Reference ( Patient | Practitioner | RelatedPerson | Device | HealthcareService | Location ) Person, Location, HealthcareService, or Device
. . . participantStatus ?! Σ 1..1 code accepted | declined | tentative | in-process | completed | needs-action | entered-in-error
ParticipationStatus ( Required )
. . . comment 0..1 string Additional comments

doco Documentation for this format

UML Diagram ( Legend )

AppointmentResponse ( DomainResource ) This records identifiers associated with this appointment response 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 identifier : Identifier [0..*] Appointment that this response is replying to appointment : Reference [1..1] « Appointment » Date/Time that the appointment is to take place, or requested new start time start : instant [0..1] This may be either the same as the appointment request to confirm the details of the appointment, or alternately a new time to request a re-negotiation of the end time end : instant [0..1] Role of participant in the appointment participantType : CodeableConcept [0..*] « Role of participant in encounter. (Strength=Extensible) ParticipantType + » A Person, Location, HealthcareService, or Device that is participating in the appointment actor : Reference [0..1] « Patient | Practitioner | RelatedPerson | Device | HealthcareService | Location » Participation status of the participant. When the status is declined or tentative if the start/end times are different to the appointment, then these times should be interpreted as a requested time change. When the status is accepted, the times can either be the time of the appointment (as a confirmation of the time) or can be empty (this element modifies the meaning of other elements) participantStatus : code [1..1] « The Participation status of an appointment. (Strength=Required) ParticipationStatus ! » Additional comments about the appointment comment : string [0..1]

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:AppointmentResponse;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:AppointmentResponse.identifier [ Identifier ], ... ; # 0..* External Ids for this item
  fhir:AppointmentResponse.appointment [ Reference(Appointment) ]; # 1..1 Appointment this response relates to
  fhir:AppointmentResponse.start [ instant ]; # 0..1 Time from appointment, or requested new start time
  fhir:AppointmentResponse.end [ instant ]; # 0..1 Time from appointment, or requested new end time
  fhir:AppointmentResponse.participantType [ CodeableConcept ], ... ; # 0..* Role of participant in the appointment
  fhir:AppointmentResponse.actor [ Reference(Patient|Practitioner|RelatedPerson|Device|HealthcareService|Location) ]; # 0..1 Person, Location, HealthcareService, or Device
  fhir:AppointmentResponse.participantStatus [ code ]; # 1..1 accepted | declined | tentative | in-process | completed | needs-action | entered-in-error
  fhir:AppointmentResponse.comment [ string ]; # 0..1 Additional comments
]

Changes since R3

  • No Changes
AppointmentResponse

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass 2 fail round-trip testing and all 2 r3 resources are valid.). Note: these have note yet been updated to be R3 to R4 invalid (0 errors). )

Structure

Name Flags Card. Type Description & Constraints doco
. . AppointmentResponse I TU DomainResource A reply to an appointment request for a patient and/or practitioner(s), such as a confirmation or rejection
+ Rule: Either the participantType or actor must be specified
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..* Identifier External Ids for this item
. . . appointment Σ 1..1 Reference ( Appointment ) Appointment this response relates to
. . . start 0..1 instant Time from appointment, or requested new start time
. . . end 0..1 instant Time from appointment, or requested new end time
. . . participantType Σ 0..* CodeableConcept Role of participant in the appointment
ParticipantType Participant type ( Extensible )
. . . actor Σ 0..1 Reference ( Patient | Practitioner | RelatedPerson | Device | HealthcareService | Location ) Person, Location, HealthcareService, or Device
. . . participantStatus ?! Σ 1..1 code accepted | declined | tentative | in-process | completed | needs-action | entered-in-error
ParticipationStatus ( Required )
. . . comment 0..1 string Additional comments

doco Documentation for this format

UML Diagram ( Legend )

AppointmentResponse ( DomainResource ) This records identifiers associated with this appointment response 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 identifier : Identifier [0..*] Appointment that this response is replying to appointment : Reference [1..1] « Appointment » Date/Time that the appointment is to take place, or requested new start time start : instant [0..1] This may be either the same as the appointment request to confirm the details of the appointment, or alternately a new time to request a re-negotiation of the end time end : instant [0..1] Role of participant in the appointment participantType : CodeableConcept [0..*] « Role of participant in encounter. (Strength=Extensible) ParticipantType + » A Person, Location, HealthcareService, or Device that is participating in the appointment actor : Reference [0..1] « Patient | Practitioner | RelatedPerson | Device | HealthcareService | Location » Participation status of the participant. When the status is declined or tentative if the start/end times are different to the appointment, then these times should be interpreted as a requested time change. When the status is accepted, the times can either be the time of the appointment (as a confirmation of the time) or can be empty (this element modifies the meaning of other elements) participantStatus : code [1..1] « The Participation status of an appointment. (Strength=Required) ParticipationStatus ! » Additional comments about the appointment comment : string [0..1]

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:AppointmentResponse;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:AppointmentResponse.identifier [ Identifier ], ... ; # 0..* External Ids for this item
  fhir:AppointmentResponse.appointment [ Reference(Appointment) ]; # 1..1 Appointment this response relates to
  fhir:AppointmentResponse.start [ instant ]; # 0..1 Time from appointment, or requested new start time
  fhir:AppointmentResponse.end [ instant ]; # 0..1 Time from appointment, or requested new end time
  fhir:AppointmentResponse.participantType [ CodeableConcept ], ... ; # 0..* Role of participant in the appointment
  fhir:AppointmentResponse.actor [ Reference(Patient|Practitioner|RelatedPerson|Device|HealthcareService|Location) ]; # 0..1 Person, Location, HealthcareService, or Device
  fhir:AppointmentResponse.participantStatus [ code ]; # 1..1 accepted | declined | tentative | in-process | completed | needs-action | entered-in-error
  fhir:AppointmentResponse.comment [ string ]; # 0..1 Additional comments
]

Changes since DSTU2 Release 3

  • No Changes
AppointmentResponse

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass 2 fail round-trip testing and all 2 r3 resources are valid.). Note: these have note yet been updated to be R3 to R4 invalid (0 errors). )

 

Alternate See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions & the dependency analysis

12.11.2.1 Terminology Bindings

Path Definition Type Reference
AppointmentResponse.participantType Role of participant in encounter. Extensible ParticipantType
AppointmentResponse.participantStatus The Participation status of an appointment. Required ParticipationStatus

12.11.2.2 Constraints

id Level Location Description Expression
apr-1 : Rule (base) Either the participantType or actor must be specified ( expression : participantType.exists() or actor.exists() )

12.11.3 Notes:

12.11.3.1 Time zones and recurring appointments

Recurring appointments need to have the time zone defined in which the values were entered. Knowing that the start time was at 9:00:00Z+10 does not mean that the same time in 2 weeks is actually the same.

For example, if this was a time in Brisbane Australia, this time would be the same (in respect to its offset from UTC), however if this was for Melbourne Australia, during the daylight savings period Melbourne time zone becomes +11. So without the additional information as to which time zone it was created in, scheduling a 9am appointment every Wednesday would not be possible.

12.11.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
actor reference The Person, Location/HealthcareService or Device that this appointment response replies for AppointmentResponse.actor
( Practitioner , Device , Patient , HealthcareService , RelatedPerson , Location )
appointment reference The appointment that the response is attached to AppointmentResponse.appointment
( Appointment )
identifier token An Identifier in this appointment response AppointmentResponse.identifier
location reference This Response is for this Location AppointmentResponse.actor AppointmentResponse.actor.where(resolve() is Location)
( Location )
part-status token The participants acceptance status for this appointment AppointmentResponse.participantStatus
patient reference This Response is for this Patient AppointmentResponse.actor AppointmentResponse.actor.where(resolve() is Patient)
( Patient )
practitioner reference This Response is for this Practitioner AppointmentResponse.actor AppointmentResponse.actor.where(resolve() is Practitioner)
( Practitioner )