1.0.0 - release

CambioOpenServicesIG - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AppointmentSe - Detailed Descriptions

Active as of 2025-06-16

Definitions for the AppointmentSe resource profile.

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

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:permittedPatientActions
Slice NamepermittedPatientActions
Definition

Use to describe what a patient is permitted to do in the area of booking, re-booking and cancellations.

ShortDescribes what actions the patient has permission for to do with the appointment.
Control0..*
This element is affected by the following invariants: ele-1
TypeExtension(CommonPermittedPatientActions) (Extension Type: Coding)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Appointment.extension:serviceProvider
Slice NameserviceProvider
Definition

Organizational service provider for e.g an appointment

ShortOrganizational unit that is responsible for the appointment.
Comments

In COSMIC this corresponds to a Responsible Unit.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(CommonServiceProvider) (Extension Type: Reference)
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())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Appointment.extension:url
Slice Nameurl
Definition

Meeting URL for the appointment so that participants can connect

ShortMeeting URL for the appointment to which participants can connect.
Comments

This can be used for e-visits etc to connect to a video appointment

Control0..1
TypeExtension(AppointmentUrl) (Extension Type: url)
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())
10. Appointment.extension:urlLabel
Slice NameurlLabel
Definition

Label of the URL for video meeting that can be displayed to the user.

ShortLabel of the meeting URL that can be displayed to the user.
Control0..1
TypeExtension(AppointmentUrlLabel) (Extension Type: string)
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())
12. Appointment.extension:urlNotAvailableMessage
Slice NameurlNotAvailableMessage
Definition

Optional Extension Element - found in all resources.

ShortMessage explaining why the meeting URL is not available.
Control0..1
TypeExtension(AppointmentUrlNotAvailableMessage) (Extension Type: string)
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())
14. Appointment.extension:class
Slice Nameclass
Definition

Used for describing the contact type similar to encounter class.

ShortCode that defines what type of encounter the appointment is for. For example if the appointment is a video meeting, the class will have the code VIDEOCONF.
Control0..1
TypeExtension(AppointmentEncounterClass) (Extension Type: Coding)
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())
16. Appointment.extension:navigationInstruction
Slice NamenavigationInstruction
Definition

An Extension

ShortInstructions for navigating to the care unit where the appointment will be attended.
Control0..1
TypeExtension(AppointmentNavigationInstruction) (Extension Type: string)
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())
18. 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())
20. 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..0*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Appointment.status
Definition

The overall status of the Appointment


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.

Shortproposed | 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.

Supported statuses: waitlist, booked, arrived, fulfilled, cancelled, noshow, entered-in-error


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
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. 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..01
BindingFor example codes, see AppointmentCancellationReasonhttp://hl7.org/fhir/ValueSet/appointment-cancellation-reason
(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()))
32. 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
Comments

This is removed as in COSMIC this is represented by a HealthcareService. See extension HealthcareServiceReference.

Control0..0*
BindingFor example codes, see ServiceCategoryhttp://hl7.org/fhir/ValueSet/service-category
(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()))
34. 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

Cambio products do not support a specific coded service. This would be represented as dedicated activity resources or similar instead of just plain codes on the Appointment.


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..0*
BindingFor example codes, see ServiceTypehttp://hl7.org/fhir/ValueSet/service-type
(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()))
36. 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..0*
BindingThe codes SHOULD be taken from PracticeSettingCodeValueSethttp://hl7.org/fhir/ValueSet/c80-practice-codes
(preferred to http://hl7.org/fhir/ValueSet/c80-practice-codes)
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Appointment.appointmentType
Definition

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

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

COSMIC supports the following: EMERGENCY, FOLLOWUP, ROUTINE, WALKIN

ROUTINE is used as "New" as opposed to "Follow-Up"

Control0..01
BindingThe codes SHOULD be taken from hl7VS-appointmentReasonCodeshttp://terminology.hl7.org/ValueSet/v2-0276
(preferred to http://terminology.hl7.org/ValueSet/v2-0276)
TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Appointment.reasonCode
Definition

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

ShortCoded reason this appointment is scheduled
Control0..0*
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
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. 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.

ShortReason the appointment is to take place (resource)
Control0..0*
TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. 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

Not supported


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..01
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()))
46. 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()))
SlicingThis element introduces a set of slices on Appointment.supportingInformation. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 48. Appointment.supportingInformation:encounter
    Slice Nameencounter
    Definition

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

    ShortAdditional information to support the appointment
    Control0..1*
    TypeReference(Encounter, Resource)
    Is Modifierfalse
    Summaryfalse
    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..01
    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..0*
    TypeReference(Slot)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    55. 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..01
    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()))
    57. Appointment.comment
    Definition

    Additional comments about the appointment to the patient. Can be specific information to the patient concerning the appointment, e.g. printout information around the offers of the unit (Vårdtjänsten) and e.g. how the meeting will be held.


    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()))
    59. Appointment.patientInstruction
    Definition

    General information to the patient, e.g. opening/closing times of the unit etc.


    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()))
    61. 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..0*
    TypeReference(ServiceRequest)
    Is Modifierfalse
    Summaryfalse
    Alternate NamesincomingReferral
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    63. Appointment.participant
    Definition

    List of participants involved in the appointment.

    ShortParticipants involved in appointment
    Control1..*
    TypeBackboneElement
    Is Modifierfalse
    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())
    SlicingThis element introduces a set of slices on Appointment.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 65. 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())
      67. 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()))
      69. Appointment.participant:patient
      Slice Namepatient
      Definition

      List of participants involved in the appointment.

      ShortParticipants involved in appointment
      Control01..1*
      TypeBackboneElement
      Is Modifierfalse
      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())
      71. Appointment.participant:patient.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())
      73. Appointment.participant:patient.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()))
      75. Appointment.participant:location
      Slice Namelocation
      Definition

      Performing unit for the Appointment


      List of participants involved in the appointment.

      ShortPerforming unit for the AppointmentParticipants involved in appointment
      Control01..1*
      TypeBackboneElement
      Is Modifierfalse
      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())
      77. Appointment.participant:location.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())
      79. Appointment.participant:location.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()))
      81. Appointment.participant:practitioner
      Slice Namepractitioner
      Definition

      List of participants involved in the appointment.

      ShortParticipants involved in appointment
      Control01..*
      TypeBackboneElement
      Is Modifierfalse
      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())
      83. Appointment.participant:practitioner.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())
      85. Appointment.participant:practitioner.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 ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
      (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()))
      SlicingThis element introduces a set of slices on Appointment.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ coding.code
      • 87. Appointment.participant:practitioner.type:primaryPerformer
        Slice NameprimaryPerformer
        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 ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
        (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()))
        89. Appointment.participant:practitioner.type:secondaryPerformer
        Slice NamesecondaryPerformer
        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 ParticipantTypehttp://hl7.org/fhir/ValueSet/encounter-participant-type
        (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()))
        91. Appointment.participant:practitioner.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()))
        93. Appointment.participant:device
        Slice Namedevice
        Definition

        List of participants involved in the appointment.

        ShortParticipants involved in appointment
        Control01..0*
        TypeBackboneElement
        Is Modifierfalse
        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())
        97. Appointment.participant:healthcareService
        Slice NamehealthcareService
        Definition

        List of participants involved in the appointment.

        ShortParticipants involved in appointment
        Control01..1*
        TypeBackboneElement
        Is Modifierfalse
        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())
        99. Appointment.participant:healthcareService.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())
        101. Appointment.participant:healthcareService.actor
        Definition

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

        ShortPerson, Location/HealthcareService or Device
        Control0..1
        TypeReference(HealthcareServiceLiteSe, 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()))
        103. Appointment.participant:healthcareService.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()))
        105. Appointment.participant:practitionerRole
        Slice NamepractitionerRole
        Definition

        List of participants involved in the appointment.

        ShortParticipants involved in appointment
        Control01..0*
        TypeBackboneElement
        Is Modifierfalse
        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())
        109. Appointment.requestedPeriod
        Definition

        Suggested or targeted date range for when the appointment should occur


        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 maps to COSMIC's notification date


        This does not introduce a capacity for recurring appointments.

        Control0..0*
        TypePeriod
        Is Modifierfalse
        Summaryfalse
        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 foundhere

        0. Appointment
        2. Appointment.extension:permittedPatientActions
        Slice NamepermittedPatientActions
        ShortDescribes what actions the patient has permission for to do with the appointment.
        4. Appointment.extension:serviceProvider
        Slice NameserviceProvider
        ShortOrganizational unit that is responsible for the appointment.
        6. Appointment.extension:url
        Slice Nameurl
        ShortMeeting URL for the appointment to which participants can connect.
        Control0..*
        TypeExtension(AppointmentUrl) (Extension Type: url)
        8. Appointment.extension:urlLabel
        Slice NameurlLabel
        ShortLabel of the meeting URL that can be displayed to the user.
        Control0..1
        TypeExtension(AppointmentUrlLabel) (Extension Type: string)
        10. Appointment.extension:urlNotAvailableMessage
        Slice NameurlNotAvailableMessage
        ShortMessage explaining why the meeting URL is not available.
        Control0..1
        TypeExtension(AppointmentUrlNotAvailableMessage) (Extension Type: string)
        12. Appointment.extension:class
        Slice Nameclass
        ShortCode that defines what type of encounter the appointment is for. For example if the appointment is a video meeting, the class will have the code VIDEOCONF.
        Control0..1
        TypeExtension(AppointmentEncounterClass) (Extension Type: Coding)
        14. Appointment.extension:navigationInstruction
        Slice NamenavigationInstruction
        ShortInstructions for navigating to the care unit where the appointment will be attended.
        Control0..1
        TypeExtension(AppointmentNavigationInstruction) (Extension Type: string)
        16. Appointment.identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..0
        18. Appointment.cancelationReason
        Control0..0
        20. Appointment.specialty
        Control0..0
        22. Appointment.appointmentType
        Control0..0
        24. Appointment.reasonCode
        Control0..0
        26. Appointment.reasonReference
        Control0..0
        28. Appointment.supportingInformation
        SlicingThis element introduces a set of slices on Appointment.supportingInformation. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 30. Appointment.supportingInformation:encounter
          Slice Nameencounter
          Control0..1
          TypeReference(Encounter)
          32. Appointment.minutesDuration
          Control0..0
          34. Appointment.slot
          Control0..0
          36. Appointment.created
          Control0..0
          38. Appointment.comment
          Definition

          Additional comments about the appointment to the patient. Can be specific information to the patient concerning the appointment, e.g. printout information around the offers of the unit (Vårdtjänsten) and e.g. how the meeting will be held.

          40. Appointment.patientInstruction
          Definition

          General information to the patient, e.g. opening/closing times of the unit etc.

          42. Appointment.basedOn
          Control0..0
          44. Appointment.participant:location
          Slice Namelocation
          Definition

          Performing unit for the Appointment

          ShortPerforming unit for the Appointment
          46. Appointment.participant:practitioner
          Slice Namepractitioner
          48. Appointment.participant:practitioner.type
          SlicingThis element introduces a set of slices on Appointment.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ coding.code
          • 50. Appointment.participant:practitioner.type:primaryPerformer
            Slice NameprimaryPerformer
            Control0..*
            52. Appointment.participant:practitioner.type:primaryPerformer.coding
            54. Appointment.participant:practitioner.type:primaryPerformer.coding.code
            Definition

            The principal or primary performer of the appointment. In COMSIC this corresponds to the main staff for the appointment.

            ShortThe principal or primary performer of the appointment.
            Control1..?
            Fixed ValuePPRF
            56. Appointment.participant:practitioner.type:secondaryPerformer
            Slice NamesecondaryPerformer
            Control0..*
            58. Appointment.participant:practitioner.type:secondaryPerformer.coding
            60. Appointment.participant:practitioner.type:secondaryPerformer.coding.code
            Definition

            A person assisting in an act through his substantial presence and involvement This includes: assistants, technicians, associates, or whatever the job titles may be.

            ShortA secondary performer in the appointment.
            Control1..?
            Fixed ValueSPRF
            62. Appointment.participant:device
            Slice Namedevice
            Control0..0
            64. Appointment.participant:healthcareService
            Slice NamehealthcareService
            66. Appointment.participant:healthcareService.actor
            TypeReference(HealthcareServiceLiteSe)
            68. Appointment.participant:practitionerRole
            Slice NamepractitionerRole
            Control0..0
            70. Appointment.requestedPeriod
            Control0..0

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

            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:permittedPatientActions
              Slice NamepermittedPatientActions
              Definition

              Use to describe what a patient is permitted to do in the area of booking, re-booking and cancellations.

              ShortDescribes what actions the patient has permission for to do with the appointment.
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension(CommonPermittedPatientActions) (Extension Type: Coding)
              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())
              18. Appointment.extension:serviceProvider
              Slice NameserviceProvider
              Definition

              Organizational service provider for e.g an appointment

              ShortOrganizational unit that is responsible for the appointment.
              Comments

              In COSMIC this corresponds to a Responsible Unit.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(CommonServiceProvider) (Extension Type: Reference)
              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())
              20. Appointment.extension:url
              Slice Nameurl
              Definition

              Meeting URL for the appointment so that participants can connect

              ShortMeeting URL for the appointment to which participants can connect.
              Comments

              This can be used for e-visits etc to connect to a video appointment

              Control0..1
              TypeExtension(AppointmentUrl) (Extension Type: url)
              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())
              22. Appointment.extension:urlLabel
              Slice NameurlLabel
              Definition

              Label of the URL for video meeting that can be displayed to the user.

              ShortLabel of the meeting URL that can be displayed to the user.
              Control0..1
              TypeExtension(AppointmentUrlLabel) (Extension Type: string)
              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())
              24. Appointment.extension:urlNotAvailableMessage
              Slice NameurlNotAvailableMessage
              Definition

              Optional Extension Element - found in all resources.

              ShortMessage explaining why the meeting URL is not available.
              Control0..1
              TypeExtension(AppointmentUrlNotAvailableMessage) (Extension Type: string)
              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())
              26. Appointment.extension:class
              Slice Nameclass
              Definition

              Used for describing the contact type similar to encounter class.

              ShortCode that defines what type of encounter the appointment is for. For example if the appointment is a video meeting, the class will have the code VIDEOCONF.
              Control0..1
              TypeExtension(AppointmentEncounterClass) (Extension Type: Coding)
              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())
              28. Appointment.extension:navigationInstruction
              Slice NamenavigationInstruction
              Definition

              An Extension

              ShortInstructions for navigating to the care unit where the appointment will be attended.
              Control0..1
              TypeExtension(AppointmentNavigationInstruction) (Extension Type: string)
              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())
              30. 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())
              32. 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..0
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. Appointment.status
              Definition

              The overall status of the Appointment

              Shortproposed | 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.

              Supported statuses: waitlist, booked, arrived, fulfilled, cancelled, noshow, entered-in-error

              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
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. 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..0
              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()))
              46. 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
              Comments

              This is removed as in COSMIC this is represented by a HealthcareService. See extension HealthcareServiceReference.

              Control0..0
              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()))
              48. 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

              Cambio products do not support a specific coded service. This would be represented as dedicated activity resources or similar instead of just plain codes on the Appointment.

              Control0..0
              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()))
              50. 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..0
              BindingThe codes SHOULD be taken from PracticeSettingCodeValueSet
              (preferred to http://hl7.org/fhir/ValueSet/c80-practice-codes)
              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. Appointment.appointmentType
              Definition

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

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

              COSMIC supports the following: EMERGENCY, FOLLOWUP, ROUTINE, WALKIN

              ROUTINE is used as "New" as opposed to "Follow-Up"

              Control0..0
              BindingThe codes SHOULD be taken from hl7VS-appointmentReasonCodes
              (preferred to http://terminology.hl7.org/ValueSet/v2-0276)
              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. Appointment.reasonCode
              Definition

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

              ShortCoded reason this appointment is scheduled
              Control0..0
              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
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. 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.

              ShortReason the appointment is to take place (resource)
              Control0..0
              TypeReference(Condition, Procedure, Observation, ImmunizationRecommendation)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. 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

              Not supported

              Control0..0
              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()))
              60. 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()))
              62. 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()))
              SlicingThis element introduces a set of slices on Appointment.supportingInformation. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 64. Appointment.supportingInformation:encounter
                Slice Nameencounter
                Definition

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

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

                Date/Time that the appointment is to take place.

                ShortWhen appointment is to take place
                Comments

                Start time of the appointment. This does not have to be the same as the Slot start time.

                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()))
                68. Appointment.end
                Definition

                Date/Time that the appointment is to conclude.

                ShortWhen appointment is to conclude
                Comments

                End time of the appointment

                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()))
                70. 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..0
                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()))
                72. Appointment.slot
                Definition

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

                ShortThe slots that this appointment is filling
                Control0..0
                TypeReference(Slot)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                88. 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..0
                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()))
                90. Appointment.comment
                Definition

                Additional comments about the appointment to the patient. Can be specific information to the patient concerning the appointment, e.g. printout information around the offers of the unit (Vårdtjänsten) and e.g. how the meeting will be held.

                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()))
                92. Appointment.patientInstruction
                Definition

                General information to the patient, e.g. opening/closing times of the unit etc.

                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()))
                94. 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..0
                TypeReference(ServiceRequest)
                Is Modifierfalse
                Summaryfalse
                Alternate NamesincomingReferral
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                96. Appointment.participant
                Definition

                List of participants involved in the appointment.

                ShortParticipants involved in appointment
                Control1..*
                TypeBackboneElement
                Is Modifierfalse
                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()))
                SlicingThis element introduces a set of slices on Appointment.participant. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 98. 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
                  100. 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())
                  102. 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())
                  104. 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()))
                  106. 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()))
                  108. 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()))
                  110. 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()))
                  112. 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()))
                  114. Appointment.participant:patient
                  Slice Namepatient
                  Definition

                  List of participants involved in the appointment.

                  ShortParticipants involved in appointment
                  Control0..1
                  TypeBackboneElement
                  Is Modifierfalse
                  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()))
                  116. Appointment.participant:patient.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
                  118. Appointment.participant:patient.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())
                  120. Appointment.participant:patient.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())
                  122. Appointment.participant:patient.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()))
                  124. Appointment.participant:patient.actor
                  Definition

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

                  ShortPerson, Location/HealthcareService or Device
                  Control0..1
                  TypeReference(Patient)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  126. Appointment.participant:patient.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()))
                  128. Appointment.participant:patient.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()))
                  130. Appointment.participant:patient.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()))
                  132. Appointment.participant:location
                  Slice Namelocation
                  Definition

                  Performing unit for the Appointment

                  ShortPerforming unit for the Appointment
                  Control0..1
                  TypeBackboneElement
                  Is Modifierfalse
                  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()))
                  134. Appointment.participant:location.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
                  136. Appointment.participant:location.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())
                  138. Appointment.participant:location.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())
                  140. Appointment.participant:location.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()))
                  142. Appointment.participant:location.actor
                  Definition

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

                  ShortPerson, Location/HealthcareService or Device
                  Control0..1
                  TypeReference(Location)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  144. Appointment.participant:location.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()))
                  146. Appointment.participant:location.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()))
                  148. Appointment.participant:location.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()))
                  150. Appointment.participant:practitioner
                  Slice Namepractitioner
                  Definition

                  List of participants involved in the appointment.

                  ShortParticipants involved in appointment
                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  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()))
                  152. Appointment.participant:practitioner.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
                  154. Appointment.participant:practitioner.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())
                  156. Appointment.participant:practitioner.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())
                  158. Appointment.participant:practitioner.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()))
                  SlicingThis element introduces a set of slices on Appointment.participant.type. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ coding.code
                  • 160. Appointment.participant:practitioner.type:primaryPerformer
                    Slice NameprimaryPerformer
                    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()))
                    162. Appointment.participant:practitioner.type:primaryPerformer.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
                    164. Appointment.participant:practitioner.type:primaryPerformer.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())
                    SlicingThis element introduces a set of slices on Appointment.participant.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 166. Appointment.participant:practitioner.type:primaryPerformer.coding
                      Definition

                      A reference to a code defined by a terminology system.

                      ShortCode defined by a terminology system
                      Comments

                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                      Control0..*
                      TypeCoding
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Allows for alternative encodings within a code system, and translations to other code systems.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      168. Appointment.participant:practitioner.type:primaryPerformer.coding.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
                      170. Appointment.participant:practitioner.type:primaryPerformer.coding.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())
                      SlicingThis element introduces a set of slices on Appointment.participant.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 172. Appointment.participant:practitioner.type:primaryPerformer.coding.system
                        Definition

                        The identification of the code system that defines the meaning of the symbol in the code.

                        ShortIdentity of the terminology system
                        Comments

                        The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                        Control0..1
                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to be unambiguous about the source of the definition of the symbol.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        174. Appointment.participant:practitioner.type:primaryPerformer.coding.version
                        Definition

                        The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                        ShortVersion of the system - if relevant
                        Comments

                        Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                        NoteThis is a business version Id, not a resource version Id (see discussion)
                        Control0..1
                        Typestring
                        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()))
                        176. Appointment.participant:practitioner.type:primaryPerformer.coding.code
                        Definition

                        The principal or primary performer of the appointment. In COMSIC this corresponds to the main staff for the appointment.

                        ShortThe principal or primary performer of the appointment.
                        Control1..1
                        Typecode
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to refer to a particular code in the system.

                        Fixed ValuePPRF
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        178. Appointment.participant:practitioner.type:primaryPerformer.coding.display
                        Definition

                        A representation of the meaning of the code in the system, following the rules of the system.

                        ShortRepresentation defined by the system
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        180. Appointment.participant:practitioner.type:primaryPerformer.coding.userSelected
                        Definition

                        Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                        ShortIf this coding was chosen directly by the user
                        Comments

                        Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                        Control0..1
                        Typeboolean
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        182. Appointment.participant:practitioner.type:primaryPerformer.text
                        Definition

                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                        ShortPlain text representation of the concept
                        Comments

                        Very often the text is the same as a displayName of one of the codings.

                        Control0..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        184. Appointment.participant:practitioner.type:secondaryPerformer
                        Slice NamesecondaryPerformer
                        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()))
                        186. Appointment.participant:practitioner.type:secondaryPerformer.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
                        188. Appointment.participant:practitioner.type:secondaryPerformer.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())
                        SlicingThis element introduces a set of slices on Appointment.participant.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 190. Appointment.participant:practitioner.type:secondaryPerformer.coding
                          Definition

                          A reference to a code defined by a terminology system.

                          ShortCode defined by a terminology system
                          Comments

                          Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                          Control0..*
                          TypeCoding
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Allows for alternative encodings within a code system, and translations to other code systems.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          192. Appointment.participant:practitioner.type:secondaryPerformer.coding.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
                          194. Appointment.participant:practitioner.type:secondaryPerformer.coding.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())
                          SlicingThis element introduces a set of slices on Appointment.participant.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 196. Appointment.participant:practitioner.type:secondaryPerformer.coding.system
                            Definition

                            The identification of the code system that defines the meaning of the symbol in the code.

                            ShortIdentity of the terminology system
                            Comments

                            The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                            Control0..1
                            Typeuri
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to be unambiguous about the source of the definition of the symbol.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            198. Appointment.participant:practitioner.type:secondaryPerformer.coding.version
                            Definition

                            The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                            ShortVersion of the system - if relevant
                            Comments

                            Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                            NoteThis is a business version Id, not a resource version Id (see discussion)
                            Control0..1
                            Typestring
                            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()))
                            200. Appointment.participant:practitioner.type:secondaryPerformer.coding.code
                            Definition

                            A person assisting in an act through his substantial presence and involvement This includes: assistants, technicians, associates, or whatever the job titles may be.

                            ShortA secondary performer in the appointment.
                            Control1..1
                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to refer to a particular code in the system.

                            Fixed ValueSPRF
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            202. Appointment.participant:practitioner.type:secondaryPerformer.coding.display
                            Definition

                            A representation of the meaning of the code in the system, following the rules of the system.

                            ShortRepresentation defined by the system
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            204. Appointment.participant:practitioner.type:secondaryPerformer.coding.userSelected
                            Definition

                            Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                            ShortIf this coding was chosen directly by the user
                            Comments

                            Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                            Control0..1
                            Typeboolean
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            206. Appointment.participant:practitioner.type:secondaryPerformer.text
                            Definition

                            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                            ShortPlain text representation of the concept
                            Comments

                            Very often the text is the same as a displayName of one of the codings.

                            Control0..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            208. Appointment.participant:practitioner.actor
                            Definition

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

                            ShortPerson, Location/HealthcareService or Device
                            Control0..1
                            TypeReference(Practitioner)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            210. Appointment.participant:practitioner.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()))
                            212. Appointment.participant:practitioner.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()))
                            214. Appointment.participant:practitioner.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()))
                            216. Appointment.participant:device
                            Slice Namedevice
                            Definition

                            List of participants involved in the appointment.

                            ShortParticipants involved in appointment
                            Control0..0
                            TypeBackboneElement
                            Is Modifierfalse
                            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()))
                            226. Appointment.participant:healthcareService
                            Slice NamehealthcareService
                            Definition

                            List of participants involved in the appointment.

                            ShortParticipants involved in appointment
                            Control0..1
                            TypeBackboneElement
                            Is Modifierfalse
                            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()))
                            228. Appointment.participant:healthcareService.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
                            230. Appointment.participant:healthcareService.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())
                            232. Appointment.participant:healthcareService.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())
                            234. Appointment.participant:healthcareService.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()))
                            236. Appointment.participant:healthcareService.actor
                            Definition

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

                            ShortPerson, Location/HealthcareService or Device
                            Control0..1
                            TypeReference(HealthcareServiceLiteSe)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            238. Appointment.participant:healthcareService.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()))
                            240. Appointment.participant:healthcareService.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()))
                            242. Appointment.participant:healthcareService.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()))
                            244. Appointment.participant:practitionerRole
                            Slice NamepractitionerRole
                            Definition

                            List of participants involved in the appointment.

                            ShortParticipants involved in appointment
                            Control0..0
                            TypeBackboneElement
                            Is Modifierfalse
                            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()))
                            254. Appointment.requestedPeriod
                            Definition

                            Suggested or targeted date range for when the appointment should occur

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

                            This maps to COSMIC's notification date

                            Control0..0
                            TypePeriod
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))