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Appointment | Urgent & Emergency Care Appointments

A booking of a healthcare event among patient(s), related person(s) and/or device(s) for a specific date/time.

Introduction

This resource is used in two closely linked but very different scenarios.

References to FHIR Profiles

Booking

It is sent as a POST request body from the Consumer to Provider systems in order to book an appointment.

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 and time the appointment was initially created in FHIR dateTime format.
This is set by the PROVIDER not the CONSUMER.
2019-01-17T14:00:00
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, that SHOULD be present if available. [ { “reference”: “#123” } ]
incomingReferral [0..1] Optionally, the ReferralRequest provided as information to allocate to the Encounter. This may be ignored if not supported. Additional documentation can be added to the supportingInformation element. [ { “reference”: “Referral123” } ].
participant [1..1] A reference to a contained resource (see below) which describes the Patient for whom this Appointment is being booked, that SHOULD be present if available. Further participant types may be present. “participant”: [ { “actor”: { “reference”: “#P1” } } ]

Contained resources

If supported, the appointment resource SHOULD 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. Some use cases may not support all three contained resources. This should be documented in system guidance.

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

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-GB"
                    }
                }
            ]
        },
        {
            "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"
            }
        }
    ]
}

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-GB"
                    }
                }
            ]
        },
        {
            "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"
            }
        }
    ]
}

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>

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