PATIENT ADMINISTRTAION (PA) Workgroup Development Draft

5.30 Resource AppointmentResponse - Content

This resource maintained by the Patient Administration Work Group

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

5.30.1 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.

5.30.2 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. AppointmentResponse DomainResourceA reply to an appointment request for a patient and/or practitioner(s), such as a confirmation or rejection
... identifier Σ0..*IdentifierExternal Ids for this item
... appointment Σ1..1AppointmentParent appointment that this response is replying to
... participantType Σ0..*CodeableConceptRole of participant in the appointment
ParticipantType (Required)
... actor Σ0..1Patient | Practitioner | RelatedPerson | Device | HealthcareService | LocationA Person, Location/HealthcareService or Device that is participating in the appointment
... participantStatus ?! Σ1..1codeaccepted | declined | tentative | in-process | completed | needs-action
ParticipantStatus (Required)
... comment 0..1stringAdditional comments about the appointment
... start 0..1instantDate/Time that the appointment is to take place, or requested new start time
... end 0..1instantDate/Time that the appointment is to conclude, or requested new end time

UML Diagram

AppointmentResponse (DomainResource)This records identifiers associated with this appointment response concern that are defined by business processed and/ or used to refer to it when a direct URL reference to the resource itself is not appropriateidentifier : Identifier 0..*Parent appointment that this response is replying toappointment : Reference(Appointment) 1..1Role of participant in the appointmentparticipantType : CodeableConcept 0..* « Role of participant in encounterParticipantType »A Person, Location/HealthcareService or Device that is participating in the appointmentactor : Reference(Patient|Practitioner| RelatedPerson|Device|HealthcareService| Location) 0..1Participation 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 appointmentParticipantStatus »This comment is particularly important when the responder is declining, tentative or requesting another time to indicate the reasons whycomment : string 0..1This 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 timestart : instant 0..1This 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 timeend : instant 0..1

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. AppointmentResponse DomainResourceA reply to an appointment request for a patient and/or practitioner(s), such as a confirmation or rejection
... identifier Σ0..*IdentifierExternal Ids for this item
... appointment Σ1..1AppointmentParent appointment that this response is replying to
... participantType Σ0..*CodeableConceptRole of participant in the appointment
ParticipantType (Required)
... actor Σ0..1Patient | Practitioner | RelatedPerson | Device | HealthcareService | LocationA Person, Location/HealthcareService or Device that is participating in the appointment
... participantStatus ?! Σ1..1codeaccepted | declined | tentative | in-process | completed | needs-action
ParticipantStatus (Required)
... comment 0..1stringAdditional comments about the appointment
... start 0..1instantDate/Time that the appointment is to take place, or requested new start time
... end 0..1instantDate/Time that the appointment is to conclude, or requested new end time

UML Diagram

AppointmentResponse (DomainResource)This records identifiers associated with this appointment response concern that are defined by business processed and/ or used to refer to it when a direct URL reference to the resource itself is not appropriateidentifier : Identifier 0..*Parent appointment that this response is replying toappointment : Reference(Appointment) 1..1Role of participant in the appointmentparticipantType : CodeableConcept 0..* « Role of participant in encounterParticipantType »A Person, Location/HealthcareService or Device that is participating in the appointmentactor : Reference(Patient|Practitioner| RelatedPerson|Device|HealthcareService| Location) 0..1Participation 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 appointmentParticipantStatus »This comment is particularly important when the responder is declining, tentative or requesting another time to indicate the reasons whycomment : string 0..1This 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 timestart : instant 0..1This 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 timeend : instant 0..1

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON)

5.30.2.1 Terminology Bindings

PathDefinitionTypeReference
AppointmentResponse.participantType Role of participant in encounterRequiredhttp://hl7.org/fhir/vs/encounter-participant-type
AppointmentResponse.participantStatus The Participation status of an appointmentRequiredhttp://hl7.org/fhir/participantstatus

5.30.3 Notes:

  • Timezones and Recurring Appointments
  • Recurring appointments need to have the timezone in which the values were entered in defined. 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.

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

  • Placer/Filler (HL7 v2)
  • The appointment information is effectively the same between the filler and placer, and given the nature of the fhir resource, there is only a single resource for both purposes. The Placer is the actor that performs the PUT or POST operation on the resource, and the filler is the actor that receives these resource messages and processes the information and makes a decision if the appointment can be used. Brian: Does this seem right that the filler and placer are applied in this way?

  • Interaction with other Standards
  • The strong desire is that implementers of this resource should consider providing this resource in the iCalendar format as an alternative representation. Many 3rd party applications and component providers have parsers and user interface controls to display this information. This may lower the entry point to integrate outside the health-care specific applications, and into the consumer space. This would permit the easier creation of a mobile application that creates appointments in the devices native calendar.
    The iCalendar specification can be found at http://www.ietf.org/rfc/rfc2445.txt.

5.30.4 Search Parameters

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

NameTypeDescriptionPaths
actorreferenceThe Person, Location/HealthcareService or Device that this appointment response replies forAppointmentResponse.actor
(Practitioner, Device, Patient, HealthcareService, RelatedPerson, Location)
appointmentreferenceThe appointment that the response is attached toAppointmentResponse.appointment
(Appointment)
locationreferenceThis Response is for this LocationAppointmentResponse.actor
(Location)
partstatustokenThe participants acceptance status for this appointmentAppointmentResponse.participantStatus
patientreferenceThis Response is for this PatientAppointmentResponse.actor
(Patient)
practitionerreferenceThis Response is for this PractitionerAppointmentResponse.actor
(Practitioner)