Interweave Implementation Guide
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Interweave Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the STU3 profiles here.

Resource Profile: UKCoreAppointment - Detailed Descriptions

Active as of 2023-12-12

Definitions for the UKCore-Appointment resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Appointment
2. Appointment.extension
SlicingThis element introduces a set of slices on Appointment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. Appointment.extension:bookingOrganization
    Slice NamebookingOrganization
    ShortA reference to the source Organization of the booked appointment.
    Control0..1
    TypeExtension(Extension UK Core Booking Organization) (Extension Type: Reference(Organization))
    6. Appointment.extension:deliveryChannel
    Slice NamedeliveryChannel
    ShortDefines the delivery channel of a scheduled appointment.
    Control0..1
    TypeExtension(Extension UK Core Delivery Channel) (Extension Type: CodeableConcept)
    8. Appointment.status
    ShortThe overall status of the appointment.
    Must Supporttrue
    10. Appointment.specialty
    ShortThe specialty of a practitioner that would be required to perform the service requested in this appointment.
    BindingUnless not suitable, these codes SHALL be taken from UK Core Practice Setting Code
    (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode)
    Must Supporttrue
    12. Appointment.appointmentType
    ShortThe type of appointment or patient that has been booked in the slot.
    BindingUnless not suitable, these codes SHALL be taken from UK Core Appointment Reason Code
    (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-AppointmentReasonCode)

    A set of codes that define an appointment reason.

    Must Supporttrue
    14. Appointment.reasonCode
    ShortThe reason for the appointment.
    Must Supporttrue
    16. Appointment.reasonReference
    ShortA reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.
    Must Supporttrue
    18. Appointment.start
    ShortThe start time of the appointment.
    Must Supporttrue
    20. Appointment.basedOn
    ShortThe service request this appointment is allocated to assess.
    Must Supporttrue
    22. Appointment.participant
    ShortA list of participants involved in the appointment.
    Must Supporttrue

    Guidance on how to interpret the contents of this table can be found here

    0. 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).

    ShortA 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..*
    Is Modifierfalse
    Summaryfalse
    Invariantsapp-2: Either start and end are specified, or neither (start.exists() = 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' | 'waitlist')))
    app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show (Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='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())
    app-2: Either start and end are specified, or neither (start.exists() = 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' | 'waitlist')))
    app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show (Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled'))
    2. 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.

    ShortA set of rules under which this content was created
    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.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. Appointment.extension
    Definition

    An Extension


    May 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.

    ShortExtensionAdditional content defined by implementations
    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    SlicingThis element introduces a set of slices on Appointment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. Appointment.extension:bookingOrganization
      Slice NamebookingOrganization
      Definition

      An extension to record the organisation booking the appointment.

      ShortA reference to the source Organization of the booked appointment.
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension UK Core Booking Organization) (Extension Type: Reference(Organization))
      Is Modifierfalse
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      8. Appointment.extension:deliveryChannel
      Slice NamedeliveryChannel
      Definition

      An extension to record the delivery channel of a scheduled Appointment.

      ShortDefines the delivery channel of a scheduled appointment.
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Extension UK Core Delivery Channel) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. 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 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).

      ShortExtensions that cannot be ignored
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      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.

      Alternate Namesextensions, user content
      Invariantsele-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())
      12. 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.

      ShortThe overall status of the appointment.proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
      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.

      Control1..1
      BindingThe codes SHALL be taken from AppointmentStatushttp://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1
      (required to http://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1)

      The free/busy status of an appointment.

      Typecode
      Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. Appointment.specialty
      Definition

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

      ShortThe specialty of a practitioner that would be required to perform the service requested in this appointment.
      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from UK Core Practice Setting Codehttp://hl7.org/fhir/ValueSet/c80-practice-codes
      (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Appointment.appointmentType
      Definition

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

      ShortThe type of appointment or patient that has been booked in the slot.The style of appointment or patient that has been booked in the slot (not service type)
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from The codes SHOULD be taken from UK Core Appointment Reason Codehttp://terminology.hl7.org/ValueSet/v2-0276
      (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-AppointmentReasonCode)

      A set of codes that define an appointment reason.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. Appointment.reasonCode
      Definition

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

      ShortThe reason for the appointment.Coded reason this appointment is scheduled
      Control0..*
      BindingThe codes SHOULD be taken from EncounterReasonCodeshttp://hl7.org/fhir/ValueSet/encounter-reason
      (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

      The Reason for the appointment to take place.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Appointment.reasonReference
      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.

      ShortA reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.Reason the appointment is to take place (resource)
      Control0..*
      TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Appointment.start
      Definition

      Date/Time that the appointment is to take place.

      ShortThe start time of the appointment.When appointment is to take place
      Control0..1
      Typeinstant
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Appointment.basedOn
      Definition

      The service request this appointment is allocated to assess (e.g. incoming referral or procedure request).

      ShortThe service request this appointment is allocated to assess.
      Control0..*
      TypeReference(ServiceRequest)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Alternate NamesincomingReferral
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Appointment.participant
      Definition

      List of participants involved in the appointment.

      ShortA list of participants involved in the appointment.Participants involved in appointment
      Control1..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsapp-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()))
      app-1: Either the type or actor on the participant SHALL be specified (type.exists() or actor.exists())
      28. 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 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).

      ShortExtensions that cannot be ignored even if unrecognized
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      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.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-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())
      30. Appointment.participant.status
      Definition

      Participation status of the actor.

      Shortaccepted | declined | tentative | needs-action
      Control1..1
      BindingThe codes SHALL be taken from ParticipationStatushttp://hl7.org/fhir/ValueSet/participationstatus|4.0.1
      (required to http://hl7.org/fhir/ValueSet/participationstatus|4.0.1)

      The Participation status of an appointment.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. 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).

      ShortA 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..*
      Is Modifierfalse
      Summaryfalse
      Invariantsapp-2: Either start and end are specified, or neither (start.exists() = 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' | 'waitlist')))
      app-4: Cancelation reason is only used for appointments that have been cancelled, or no-show (Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='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())
      2. Appointment.id
      Definition

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

      ShortLogical id of this artifact
      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.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. 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.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. 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.

      ShortA set of rules under which this content was created
      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.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Appointment.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      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).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. 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.

      ShortText summary of the resource, for human interpretation
      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.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. 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.

      ShortContained, inline 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.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Appointment.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-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())
      SlicingThis element introduces a set of slices on Appointment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. Appointment.extension:bookingOrganization
        Slice NamebookingOrganization
        Definition

        An extension to record the organisation booking the appointment.

        ShortA reference to the source Organization of the booked appointment.
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension UK Core Booking Organization) (Extension Type: Reference(Organization))
        Is Modifierfalse
        Invariantsele-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())
        18. Appointment.extension:deliveryChannel
        Slice NamedeliveryChannel
        Definition

        An extension to record the delivery channel of a scheduled Appointment.

        ShortDefines the delivery channel of a scheduled appointment.
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Extension UK Core Delivery Channel) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Invariantsele-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())
        20. 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 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).

        ShortExtensions that cannot be ignored
        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        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.

        Alternate Namesextensions, user content
        Invariantsele-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())
        22. 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).

        ShortExternal Ids for this item
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. 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.

        ShortThe overall status of the appointment.
        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.

        Control1..1
        BindingThe codes SHALL be taken from AppointmentStatus
        (required to http://hl7.org/fhir/ValueSet/appointmentstatus|4.0.1)

        The free/busy status of an appointment.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Appointment.cancelationReason
        Definition

        The 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.

        ShortThe coded reason for the appointment being cancelled
        Control0..1
        BindingFor example codes, see AppointmentCancellationReason
        (example to http://hl7.org/fhir/ValueSet/appointment-cancellation-reason)
        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Appointment.serviceCategory
        Definition

        A broad categorization of the service that is to be performed during this appointment.

        ShortA broad categorization of the service that is to be performed during this appointment
        Control0..*
        BindingFor example codes, see ServiceCategory
        (example to http://hl7.org/fhir/ValueSet/service-category)
        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Appointment.serviceType
        Definition

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

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

        Control0..*
        BindingFor example codes, see ServiceType
        (example to http://hl7.org/fhir/ValueSet/service-type)
        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Appointment.specialty
        Definition

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

        ShortThe specialty of a practitioner that would be required to perform the service requested in this appointment.
        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from UK Core Practice Setting Code
        (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-PracticeSettingCode)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Appointment.appointmentType
        Definition

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

        ShortThe type of appointment or patient that has been booked in the slot.
        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from UK Core Appointment Reason Code
        (extensible to https://fhir.hl7.org.uk/ValueSet/UKCore-AppointmentReasonCode)

        A set of codes that define an appointment reason.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Appointment.reasonCode
        Definition

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

        ShortThe reason for the appointment.
        Control0..*
        BindingThe codes SHOULD be taken from EncounterReasonCodes
        (preferred to http://hl7.org/fhir/ValueSet/encounter-reason)

        The Reason for the appointment to take place.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Appointment.reasonReference
        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.

        ShortA reference to the Observation, Condition, Procedure, or ImmunizationRecommendation that is the reason for the appointment.
        Control0..*
        TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. 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).

        ShortUsed to make informed decisions if needing to re-prioritize
        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.

        Control0..1
        TypeunsignedInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. 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.

        ShortShown on a subject line in a meeting request, or appointment list
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Appointment.supportingInformation
        Definition

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

        ShortAdditional information to support the appointment
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Appointment.start
        Definition

        Date/Time that the appointment is to take place.

        ShortThe start time of the appointment.
        Control0..1
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Appointment.end
        Definition

        Date/Time that the appointment is to conclude.

        ShortWhen appointment is to conclude
        Control0..1
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. 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.

        ShortCan be less than start/end (e.g. estimate)
        Control0..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Appointment.slot
        Definition

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

        ShortThe slots that this appointment is filling
        Control0..*
        TypeReference(Slot)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. 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.

        ShortThe date that this appointment was initially created
        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.

        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Appointment.comment
        Definition

        Additional comments about the appointment.

        ShortAdditional comments
        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.

        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. 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).

        ShortDetailed information and instructions for the patient
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Appointment.basedOn
        Definition

        The service request this appointment is allocated to assess (e.g. incoming referral or procedure request).

        ShortThe service request this appointment is allocated to assess.
        Control0..*
        TypeReference(ServiceRequest)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Alternate NamesincomingReferral
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Appointment.participant
        Definition

        List of participants involved in the appointment.

        ShortA list of participants involved in the appointment.
        Control1..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsapp-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()))
        64. 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.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        66. 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.

        ShortAdditional content defined by implementations
        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-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())
        68. 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 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).

        ShortExtensions that cannot be ignored even if unrecognized
        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        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.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-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())
        70. Appointment.participant.type
        Definition

        Role of participant in the appointment.

        ShortRole of participant in the appointment
        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.

        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from ParticipantType
        (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type)

        Role of participant in encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Appointment.participant.actor
        Definition

        A Person, Location/HealthcareService or Device that is participating in the appointment.

        ShortPerson, Location/HealthcareService or Device
        Control0..1
        TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson, Device, HealthcareService, Location)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. 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.

        Shortrequired | optional | information-only
        Control0..1
        BindingThe codes SHALL be taken from ParticipantRequired
        (required to http://hl7.org/fhir/ValueSet/participantrequired|4.0.1)

        Is the Participant required to attend the appointment.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. Appointment.participant.status
        Definition

        Participation status of the actor.

        Shortaccepted | declined | tentative | needs-action
        Control1..1
        BindingThe codes SHALL be taken from ParticipationStatus
        (required to http://hl7.org/fhir/ValueSet/participationstatus|4.0.1)

        The Participation status of an appointment.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Appointment.participant.period
        Definition

        Participation period of the actor.

        ShortParticipation period of the actor
        Control0..1
        TypePeriod
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Appointment.requestedPeriod
        Definition

        A 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.

        ShortPotential date/time interval(s) requested to allocate the appointment within
        Comments

        This does not introduce a capacity for recurring appointments.

        Control0..*
        TypePeriod
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))