Introduction
This resource is used in two closely linked but very different scenarios.
Booking
It is sent as a POST request body from the Consumer to Provider systems in order to book an appointment.
Registering
It is sent as a POST request body from the Consumer to Registry in order to register an appointment.
References to FHIR Profiles
STU3 | Developed Profile: Appointment |
STU3 | HL7 Base Profile: Appointment |
STU3 | User Stories: - |
Key FHIR Elements for Booking
The following FHIR elements are key to this implementation when Booking an appointment:
See example resource.
The Appointment resource MUST NOT include the following data items:
| Name | Description |
|---|---|
| id | The identity of the appointment will be assigned by the Providing system at the point of booking, and MUST NOT be included in the request body. |
The Appointment resource MUST include the following data items:
| Element | Cardinality | Description | Example(s) |
|---|---|---|---|
| status | [1..1] | Status of this Appointment |
MUST be one of: booked | cancelled | entered in error
|
| contained | [1..1] | Contained resources | |
| contained[0] | [1..1] | A Contained DocumentReference resource conforming to CareConnect-DocumentReference-1 profile. | See example resource below |
| contained[1] | [1..1] | A Contained Patient resource conforming to CareConnect-Patient-1 profile. | See example resource below |
| contained[2] | [1..1] | A Contained Slot resource conforming to CareConnect-Slot-1 profile. | See example resource below |
| start | [1..1] | The time the Appointment starts in FHIR instant format (ISO 8601) | 2019-01-17T15:00:00.000Z |
| end | [1..1] | The time the Appointment ends in FHIR instant format (ISO 8601) | 2019-01-17T15:10:00.000Z |
| created | [1..1] | The date the appointment was initially created in FHIR instant format (ISO 8601). | 2019-01-17T14:00:00.000Z |
| description | [1..1] | Text describing the need for the appointment, to be shown for example in an appointment list. Note that developers should follow guidance for their use case as to appropriate content in this field. | 111 Referral |
| slot | [1..1] | The Slot that this appointment is booked into | [ { “reference”: “#slot002” } ] |
| supportingInformation | [1..1] | Reference to a contained resource (see below) which describes an associated document. | [ { “reference”: “#123” } ] |
| participant | [1..1] | A reference to a contained resource (see below) which describes the Patient for whom this Appointment is being booked | [ { “actor”: { “reference”: “#P1”, “identifier”: { “use”: “official”, “system”: “https://fhir.nhs.uk/Id/nhs-number”, “value”: “1234554321” }, “display”: “Peter James Chalmers” }, “status”: “accepted” } ] |
Contained resources
The appointment resource MUST have three contained resources. Note that contained resources are given an identifier which is only required to be unique within the scope of the containing resource, and are referenced using that identifier prefixed with a Hash # character.
Patient
A contained Patient resource which conforms to the Care Connect Patient profile. This resource is referenced in the Appointment’s participant element, and is used to convey the details of the Patient for whom the Appointment is being booked. The Patient resource MUST include the following data items:
| Name | Value | Description |
|---|---|---|
| id | Any | Any identifier, used to reference the resource from the Appointment.Participant element |
| identifier | identifier | The Patient’s NHS Number* as defined in the Care Connect Patient profile |
| name | Patient’s name | Name, including Prefix, Given and Family components |
| telecom | Contact number | The number the Patient can be called back on |
| gender |
male | female | other | unknown
|
The Patient’s gender |
| birthdate | yyyy-mm-dd | Patient’s DOB |
| address | Address | Patient’s full address |
*If you DO NOT have an NHS Number for the Patient, then you MUST NOT provide an identifier. NB If the Consumer does not provide a patient identifier, then the Provider system MUST populate this with their local identifier when accepting the booking, therefore making their identifier available in any subsequent requests for the appointment (e.g. search for Appointments for a Patient, cancel an Appointment etc.)
DocumentReference
A contained DocumentReference resource which conforms to CareConnect-DocumentReference-1 profile. This resource is referenced in the appointment’s supportingInformation element, it describes the type and identifier(s) of any supporting information, for example a CDA document which may be transferred separately. The DocumentReference resource MUST include the following data items:
| Name | Value | Description |
|---|---|---|
| id | Any | Any identifier, used to reference the resource from the Appointment.supportingInformation element |
| identifier | see below | Identifies the supporting information (i.e. CDA document) |
| identifier.system | https://tools.ietf.org/html/rfc4122 |
Indicates that the associated value is a UUID. |
| identifier.value | [UUID] | The UUID of the associated CDA (XPath: /ClinicalDocument/id/@root) |
| status | current |
Indicates that the associated document is current. No other value is expected. |
| type | A value from urn:oid:2.16.840.1.113883.2.1.3.2.4.18.17
|
Indicates the type of document |
| content | see below | Describes the actual document |
| content.attachment | Describes the actual document | |
| content.attachment.contentType | A valid mime type | Indicates the mime type of the document |
| content.attachment.language | en |
States that the document is in English |
Slot
A contained Slot resource which conforms to CareConnect-Slot-1 profile. This resource is referenced in the appointment’s slot element. The Slot resource must be contained to ensure that when booking an Appointment the correct Slot and Schedule combination are marked as ‘busy’. The Slot resource MUST include the following data items:
| Name | Value | Description |
|---|---|---|
| identifier | See below | An identifier that identifies this Slot |
| identifier.system | https://tools.ietf.org/html/rfc4122 |
Indicates that the associated value is a UUID. |
| identifier.value | [UUID] | The UUID of the Slot |
| status | One of busy | free
|
The current status of the Slot |
| start | 2019-01-17T15:00:00.000Z |
The start time of this Slot in FHIR instant format (ISO 8601) |
| end | 2019-01-17T15:00:00.000Z |
The end time of this Slot in FHIR instant format (ISO 8601) |
| schedule | Reference(Schedule) | Identifies the Schedule, which links the Slot to a HealthcareService, and optionally to a Practitioner and PractitionerRole |
Key FHIR Elements for Registering
The following FHIR elements are key to this implementation when Registering an appointment:
See example resource.
When registering, the Appointment resource MUST NOT include the following data items:
| Name | Description |
|---|---|
| id | The identity of the appointment will be assigned by the Providing system at the point of booking, and MUST NOT be included in the request body. |
| contained | No additional resources should be contained in the appointment |
| supportingInformation | No supporting Information should be included in the registry. |
| description | No description should be included in the registry. |
| slot | The details of the slot are irrelevant for the purposes of the registry. |
When registering, the Appointment resource MUST include the following data items:
| Element | Cardinality | Description | Example(s) |
|---|---|---|---|
| status | [1..1] | Status of this Appointment |
MUST be one of: booked | cancelled | entered in error
|
| start | [1..1] | The time the Appointment starts in FHIR instant format (ISO 8601) | 2019-01-17T15:00:00.000Z |
| end | [1..1] | The time the Appointment ends in FHIR instant format (ISO 8601) | 2019-01-17T15:10:00.000Z |
| created | [1..1] | The date the appointment was initially created in FHIR instant format (ISO 8601). | 2019-01-17T15:00:00.000Z |
| identifier | [1..1] | The details of the appointment which is being registered | |
| identifier.system | [1..1] | Defines that the value is a URL | Fixed value: urn:ietf:rfc:3986
|
| identifier.value | [1..1] | The URL of the appointment that is being registered | https://ProviderBaseURL/Appointment/1234567890 |
| participant | [1..1] | A reference to a contained resource (see below) which describes the Patient for whom this Appointment is being booked | [ { “actor”: { “reference”: “identifier”: { “use”: “official”, “system”: “https://fhir.nhs.uk/Id/nhs-number”, “value”: “1234554321” }, “display”: “Peter James Chalmers” }, “status”: “accepted” } ] |
Key FHIR Elements for Cancelling
The body is a valid Appointment resource which conforms to the relevant profile. NB The appointment resource MUST be retrieved from the Provider system in order to ensure that no data is lost.
See example resource.
The following data items in the retrieved Appointment resource MUST be changed as defined:
| Name | Value | Description |
|---|---|---|
| status | cancelled |
Indicates that the Appointment is being changed to a cancelled state. |
No other elements of the Appointment resource may be changed
Key FHIR Elements for Cancelling a registered Appointment
The body is a valid Appointment resource which conforms to the relevant profile. NB The appointment resource MUST be retrieved from the Registry in order to ensure that no data is lost.
See example resource.
The following data items in the retrieved Appointment resource MUST be changed as defined:
| Name | Value | Description |
|---|---|---|
| status | cancelled |
Indicates that the Appointment is being changed to a cancelled state. |
No other elements of the Appointment resource may be changed
Booking example resource
{
"resourceType": "Appointment",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Appointment-1"
]
},
"contained": [
{
"resourceType": "DocumentReference",
"id": "123",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-DocumentReference-1"
]
},
"identifier": [
{
"system": "https://tools.ietf.org/html/rfc4122",
"value": "6b9c59dd-675b-4026-98db-f608ef501e6e"
}
],
"status": "current",
"type": {
"coding": [
{
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.17",
"code": "POCD_MT200001GB02",
"display": "Integrated Urgent Care Report"
}
]
},
"indexed": "2018-12-20T09:43:41+11:00",
"content": [
{
"attachment": {
"contentType": "application/hl7-v3+xml",
"language": "en"
}
}
]
},
{
"resourceType": "Patient",
"id": "P1",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"
]
},
"identifier": [
{
"extension": [
{
"url": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1",
"code": "01",
"display": "Number present and verified"
}
]
}
}
],
"use": "official",
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "1234554321"
}
],
"name": [
{
"use": "official",
"family": "Chalmers",
"given": [
"Peter"
],
"prefix": [
"Mr"
]
}
],
"telecom": [
{
"system": "phone",
"value": "01234 567 890",
"use": "home",
"rank": 1
}
],
"gender": "male",
"birthDate": "1974-12-25",
"address": [
{
"use": "home",
"text": "123 High Street, Leeds LS1 4HR",
"line": [
"123 High Street",
"Leeds"
],
"city": "Leeds",
"postalCode": "LS1 4HR"
}
]
},
{
"resourceType": "Slot",
"id": "slot002",
"identifier": [
{
"system": "https://tools.ietf.org/html/rfc4122",
"value": "1db79eb3-72f8-4569-a8dc-af8759797e0f"
}
],
"schedule": {
"reference": "Schedule/sched1111"
},
"status": "busy",
"start": "2019-01-17T15:00:00.000Z",
"end": "2019-01-17T15:30:00.000Z"
}
],
"status": "booked",
"description": "Reason for calling",
"supportingInformation": [
{
"reference": "#123"
}
],
"start": "2019-01-17T15:00:00.000Z",
"end": "2019-01-17T15:10:00.000Z",
"slot": [
{
"reference": "#slot002"
}
],
"created": "2019-01-17T14:32:22.579+00:00",
"participant": [
{
"actor": {
"reference": "#P1",
"identifier": {
"use": "official",
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "1234554321"
},
"display": "Peter James Chalmers"
},
"status": "accepted"
}
]
}
Registering example resource
<Appointment xmlns="http://hl7.org/fhir">
<meta>
<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Appointment-1"/>
</meta>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="http://test.nhs.uk/test3"/>
</identifier>
<status value="booked"/>
<start value="2019-01-17T15:00:00.000Z"/>
<end value="2019-01-17T15:10:00.000Z"/>
<created value="2019-01-17T14:00:00.000Z"/>
<participant>
<actor>
<identifier>
<use value="official"/>
<system value="https://fhir.nhs.uk/Id/nhs-number"/>
<value value="1234554321"/>
</identifier>
</actor>
<status value="accepted"/>
</participant>
</Appointment>
Cancelling example resource
{
"resourceType": "Appointment",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Appointment-1"
]
},
"contained": [
{
"resourceType": "DocumentReference",
"id": "123",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-DocumentReference-1"
]
},
"identifier": [
{
"system": "https://tools.ietf.org/html/rfc4122",
"value": "6b9c59dd-675b-4026-98db-f608ef501e6e"
}
],
"status": "current",
"type": {
"coding": [
{
"system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.17",
"code": "POCD_MT200001GB02",
"display": "Integrated Urgent Care Report"
}
]
},
"indexed": "2018-12-20T09:43:41+11:00",
"content": [
{
"attachment": {
"contentType": "application/hl7-v3+xml",
"language": "en"
}
}
]
},
{
"resourceType": "Patient",
"id": "P1",
"meta": {
"profile": [
"https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Patient-1"
]
},
"identifier": [
{
"extension": [
{
"url": "https://fhir.hl7.org.uk/STU3/StructureDefinition/Extension-CareConnect-NHSNumberVerificationStatus-1",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.hl7.org.uk/STU3/CodeSystem/CareConnect-NHSNumberVerificationStatus-1",
"code": "01",
"display": "Number present and verified"
}
]
}
}
],
"use": "official",
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "1234554321"
}
],
"name": [
{
"use": "official",
"family": "Chalmers",
"given": [
"Peter"
],
"prefix": [
"Mr"
]
}
],
"telecom": [
{
"system": "phone",
"value": "01234 567 890",
"use": "home",
"rank": 1
}
],
"gender": "male",
"birthDate": "1974-12-25",
"address": [
{
"use": "home",
"text": "123 High Street, Leeds LS1 4HR",
"line": [
"123 High Street",
"Leeds"
],
"city": "Leeds",
"postalCode": "LS1 4HR"
}
]
},
{
"resourceType": "Slot",
"id": "slot002",
"identifier": [
{
"system": "https://tools.ietf.org/html/rfc4122",
"value": "1db79eb3-72f8-4569-a8dc-af8759797e0f"
}
],
"schedule": {
"reference": "Schedule/sched1111"
},
"status": "busy",
"start": "2019-01-17T15:00:00.000Z",
"end": "2019-01-17T15:30:00.000Z"
}
],
"status": "cancelled",
"description": "Reason for calling",
"supportingInformation": [
{
"reference": "#123"
}
],
"start": "2019-01-17T15:00:00.000Z",
"end": "2019-01-17T15:10:00.000Z",
"slot": [
{
"reference": "#slot002"
}
],
"created": "2019-01-17T14:32:22.579+00:00",
"participant": [
{
"actor": {
"reference": "#P1",
"identifier": {
"use": "official",
"system": "https://fhir.nhs.uk/Id/nhs-number",
"value": "1234554321"
},
"display": "Peter James Chalmers"
},
"status": "accepted"
}
]
}
Cancelling registered appointment example resource
<Appointment xmlns="http://hl7.org/fhir">
<id value="b7e99463-00a1-45fc-98aa-02301c103aba"/>
<meta>
<profile value="https://fhir.hl7.org.uk/STU3/StructureDefinition/CareConnect-Appointment-1"/>
</meta>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="http://test.nhs.uk/test3"/>
</identifier>
<status value="cancelled"/>
<start value="2019-02-01T10:51:23.620+00:00"/>
<end value="2019-01-17T15:10:00.000Z"/>
<created value="2019-01-17T14:00:00.000Z"/>
<participant>
<actor>
<identifier>
<use value="official"/>
<system value="https://fhir.nhs.uk/Id/nhs-number"/>
<value value="1234554321"/>
</identifier>
</actor>
<status value="accepted"/>
</participant>
</Appointment>
