AppointmentResponse

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

Schema

Elements

Name	Required	Type	Description
identifier		Identifier[]	External Ids for this item Details 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.
appointment	✓	Reference<Appointment>	Appointment this response relates to Details Appointment that this response is replying to.
start		instant	Time from appointment, or requested new start time Details Date/Time that the appointment is to take place, or requested new start time. 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 start time.
end		instant	Time from appointment, or requested new end time Details 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.
participantType		CodeableConcept[]	Role of participant in the appointment Details Role of participant in the appointment. The role of the participant can be used to declare what the actor will be doing in the scope of the referenced 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 as specified on the referenced Appointment so that they can be matched, and subsequently updated.
actor		Reference< Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location >	Person, Location, HealthcareService, or Device Details A Person, Location, HealthcareService, or Device that is participating in the appointment.
participantStatus	✓	code	accepted | declined | tentative | needs-action Details 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 is labeled as a modifier because the status contains the code entered-in-error that marks the participant as not currently valid.
comment		string	Additional comments Details Additional comments about the appointment. This comment is particularly important when the responder is declining, tentatively accepting or requesting another time to indicate the reasons why.

Search Parameters

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

Inherited Elements

Name	Required	Type	Description
id		string	Logical id of this artifact Details The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
meta		Meta	Metadata about the resource Details 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.
implicitRules		uri	A set of rules under which this content was created Details 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. 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.
language		code	Language of the resource content Details The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
text		Narrative	Text summary of the resource, for human interpretation Details 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. 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.
contained		Resource[]	Contained, inline Resources Details 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. 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.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored Details 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). 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.

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.

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.

Referenced By

• ImagingStudy