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).

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

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.

Ein Tag kann verwendet werden um zu kennzeichnen, dass die Ressource von Extern erstellt worden ist.

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine versionID verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine versionIDverfügen.

When the resource last changed - e.g. when the version changed.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein lastUpdate verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein lastUpdateverfügen.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

An Extension

Begründung zum Must Support: Termineabsagen sollten verkettbar sein, da am originalen Termin noch weitere Informationen hängen können.

An Extension

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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.

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.

Begründung zu Must Support : Im ISiK Kontext ist der Status eines Termins von entscheidender Bedeutung, um den aktuellen Stand und die Verfügbarkeit des Termins zu kommunizieren.

The free/busy status of an appointment.

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.

Begründung zu Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, einen Grund für die Absage eines Termins zu hinterlegen.

The specific service that is to be performed during this appointment.

Begründung zu Kardinalität und Must Support: Die Dienstleistungsart eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher ist dieses Feld verpflichtend (1..*) und muss unterstützt werden (MS). Aufgrund der Heterogenität von Dienstleistungen ist eine standardisierte Kodierung nicht zwingend notwendig, eine Freitextbeschreibung ist ausreichend.

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.

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

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.

The specialty of a practitioner that would be required to perform the service requested in this appointment.

Optionale Angabe aller Fachbereiche aus denen ein oder mehrere Akteure für die Durchführung des Termins benötigt werden.

Begründung zu Kardinalität und Must Support: KANN auch anhand des Kalenders, in dem ein Termin gebucht wird, ermittelt werden. Die Angabe der Fachbereiche ist optional (0..*), muss jedoch implementiert werden (MS), um die Spezialisierung hinsichtlich der zugeordneten Behandlungseinheit des Termins eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten.

A reference to a code defined by a terminology system.

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.

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

A reference to a code defined by a terminology system.

Begründung zur Kardinalität: Die Kardinalität der Fachrichtung-Eigenschaft wird auf 1..1 festgelegt, um sicherzustellen, dass genau eine Fachrichtung vorhanden ist. Dies ist notwendig, um die Spezialisierung des Termins eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten.

Hintergrund zur Entscheidung: Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024).

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

A reference to a code defined by a terminology system.

Dieses ValueSet KANN über ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verknüpft werden und darüber ggf. die Integration von Systemen erleichtern.

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

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).

Begründung Must Support: Die Priorität eines Termins ist von entscheidender Bedeutung, um die Dringlichkeit und Relevanz des Termins zu kommunizieren und zu priorisieren. Eine Priorität ist nicht zwingend erforderlich, muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, die Dringlichkeit und Relevanz des Termins abzurufen.

An Extension

Hinweis: In R5 ist die Priority ein CodeableConcept.

Begründung zu Must Support: Dieses Element ist optional (0..1), muss jedoch implementiert werden (MS), um besonders einen Notfall als solchen ausweisen zu können.

Optional Extension Element - found in all resources.

Date/Time that the appointment is to take place.

Begründung zu Kardinalität und Must Support: Der Startzeitpunkt eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS). Das Feld ist in den meisten Fällen verpflichtend, nur für die Status 'proposed', 'cancelled', 'waitlist' existiert kein Wert.

Date/Time that the appointment is to conclude.

Begründung zu Kardinalität und Must Support: Der Endzeitpunkt eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS). Das Feld ist in den meisten Fällen verpflichtend, nur für die Status 'proposed', 'cancelled', 'waitlist' existiert kein Wert.

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

Begründung zu Kardinalität und Must Support: Die Kardinalität der slot-Eigenschaft bleibt 0..*, sodass ein Termin-Requestor bei der Terminbuchung nur einen Termin und ein Verweis auf ein ISiKKalender übergeben kann. Es ist dann die Aufgabe des Termin-Repositories in Abhängigkeit der gebuchten Dienstleistung freie Terminblöcke zu finden. Diese sind im Appointment zu referenzieren.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Additional comments about the appointment.

Hinweis: Im ISiK Kontext sollte dieses Feld zur internen Kommunikation zwischen Leistungserbringern verwendet werden, z.B. für interne Notizen rund um den Termin.

Begründung zum Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, zusätzliche Informationen zum Termin zu hinterlegen und abrufen zu können.

Es gilt weiterhin die Semantik des Elements nach FHIR-Kernspezifikation:

'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.'

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).

Hinweis: Dieses Feld sollte im Kontext von ISIK verwendet werden für die Kommunikation im Sinne der Definition der FHIR-Kernspezifikation - sowohl von Systemseite (administrativ) als auch von Seiten des medizinischen Fachpersonals.

Beispiel für eine Nachricht: 'Bitte nüchtern erscheinen' etc.

Begründung zum Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, zusätzliche Informationen für Patienten zum Termin zu hinterlegen und abrufen zu können.

Es gilt weiterhin der Hinweis der FHIR Kernspezifikation: 'Note that FHIR strings SHALL NOT exceed 1MB in size'

List of participants involved in the appointment.

Hinweis: Die Kardinalität von actor.display und das MS-Flag von .status wird an die Slices vererbt und diese sind entsprechend zu implementieren.

Begründung zu Kardinalität und Must Support: Die Teilnehmer eines Termins sind von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS).

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).

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.

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.

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

Plain text narrative that identifies the resource in addition to the resource reference.

Hinweis: Für alle Target-Ressourcen SOLL ein Displaywert für die Referenz angegeben werden, sodass Systeme eine Übersicht der am Termin beteiligten Akteure anzeigen können ohne die Referenzen auflösen zu müssen. Somit kann ein Termin-Consumer direkt anzeigen welche Akteure für den Termin relevant sind.

Participation status of the actor.

The Participation status of an appointment.

List of participants involved in the appointment.

Hinweis: Im ISIK-Kontext MUSS der referenzierte Patient konform zum ISIKPatient des Basismoduls sein. Ein Sonderfall sind Patienten, über die ein Termin-Requestor oder Termin-Repository nur rudimentäre Informationen verfügt. Diese Patienten-Ressourcen sind bis zur Vervollständigung nur gegen den Kernstandard valide.

Begründung zu Kardinalität und Must Support: Die teilnehmenden Patienten eines Termins sind von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS). Hingegen kann die Patienten-Referenz separat in der $book-Operation übergeben werden, sodass hier keine verpflichtende Kardinaltiät gewählt werden kann.

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).

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.

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.

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

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Plain text narrative that identifies the resource in addition to the resource reference.

Hinweis: Für alle Target-Ressourcen SOLL ein Displaywert für die Referenz angegeben werden, sodass Systeme eine Übersicht der am Termin beteiligten Akteure anzeigen können ohne die Referenzen auflösen zu müssen. Somit kann ein Termin-Consumer direkt anzeigen welche Akteure für den Termin relevant sind.

Participation status of the actor.

The Participation status of an appointment.

List of participants involved in the appointment.

​Im ISIK-Kontext MUSS die referenzierte RelatedPerson-Ressource konform zum ISiKAngehoeriger des Basismoduls sein.

Begründung zu Kardinalität und Must Support: Die Angabe eines Angehörigen ist optional, da in vielen Fällen die Referenzierung des Patienten ausreichend ist. Bei Terminen, die durch einen Angehörigen gebucht/verwaltet werden, ist es jedoch wichtig, dass diese Information an das Termin-Repository übermittelt werden kann.

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).

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.

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.

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

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Plain text narrative that identifies the resource in addition to the resource reference.

Hinweis: Für alle Target-Ressourcen SOLL ein Displaywert für die Referenz angegeben werden, sodass Systeme eine Übersicht der am Termin beteiligten Akteure anzeigen können ohne die Referenzen auflösen zu müssen. Somit kann ein Termin-Consumer direkt anzeigen welche Akteure für den Termin relevant sind.

Participation status of the actor.

The Participation status of an appointment.

List of participants involved in the appointment.

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).

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.

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.

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

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Plain text narrative that identifies the resource in addition to the resource reference.

Hinweis: Für alle Target-Ressourcen SOLL ein Displaywert für die Referenz angegeben werden, sodass Systeme eine Übersicht der am Termin beteiligten Akteure anzeigen können ohne die Referenzen auflösen zu müssen. Somit kann ein Termin-Consumer direkt anzeigen welche Akteure für den Termin relevant sind.

Participation status of the actor.

The Participation status of an appointment.

List of participants involved in the appointment.

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).

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.

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.

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

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

Plain text narrative that identifies the resource in addition to the resource reference.

Hinweis: Für alle Target-Ressourcen SOLL ein Displaywert für die Referenz angegeben werden, sodass Systeme eine Übersicht der am Termin beteiligten Akteure anzeigen können ohne die Referenzen auflösen zu müssen. Somit kann ein Termin-Consumer direkt anzeigen welche Akteure für den Termin relevant sind.

Participation status of the actor.

The Participation status of an appointment.

bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

Ein Tag kann verwendet werden um zu kennzeichnen, dass die Ressource von Extern erstellt worden ist.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine versionID verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine versionIDverfügen.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein lastUpdate verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein lastUpdateverfügen.

Begründung zum Must Support: Termineabsagen sollten verkettbar sein, da am originalen Termin noch weitere Informationen hängen können.

Begründung zu Must Support : Im ISiK Kontext ist der Status eines Termins von entscheidender Bedeutung, um den aktuellen Stand und die Verfügbarkeit des Termins zu kommunizieren.

Begründung zu Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, einen Grund für die Absage eines Termins zu hinterlegen.

Begründung zu Kardinalität und Must Support: Die Dienstleistungsart eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher ist dieses Feld verpflichtend (1..*) und muss unterstützt werden (MS). Aufgrund der Heterogenität von Dienstleistungen ist eine standardisierte Kodierung nicht zwingend notwendig, eine Freitextbeschreibung ist ausreichend.

Optionale Angabe aller Fachbereiche aus denen ein oder mehrere Akteure für die Durchführung des Termins benötigt werden.

Begründung zu Kardinalität und Must Support: KANN auch anhand des Kalenders, in dem ein Termin gebucht wird, ermittelt werden. Die Angabe der Fachbereiche ist optional (0..*), muss jedoch implementiert werden (MS), um die Spezialisierung hinsichtlich der zugeordneten Behandlungseinheit des Termins eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten.

Begründung zur Kardinalität: Die Kardinalität der Fachrichtung-Eigenschaft wird auf 1..1 festgelegt, um sicherzustellen, dass genau eine Fachrichtung vorhanden ist. Dies ist notwendig, um die Spezialisierung des Termins eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten.

Hintergrund zur Entscheidung: Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024).

Dieses ValueSet KANN über ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verknüpft werden und darüber ggf. die Integration von Systemen erleichtern.

Begründung Must Support: Die Priorität eines Termins ist von entscheidender Bedeutung, um die Dringlichkeit und Relevanz des Termins zu kommunizieren und zu priorisieren. Eine Priorität ist nicht zwingend erforderlich, muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, die Dringlichkeit und Relevanz des Termins abzurufen.

Hinweis: In R5 ist die Priority ein CodeableConcept.

Begründung zu Must Support: Dieses Element ist optional (0..1), muss jedoch implementiert werden (MS), um besonders einen Notfall als solchen ausweisen zu können.

Begründung zu Kardinalität und Must Support: Der Startzeitpunkt eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS). Das Feld ist in den meisten Fällen verpflichtend, nur für die Status 'proposed', 'cancelled', 'waitlist' existiert kein Wert.

Begründung zu Kardinalität und Must Support: Der Endzeitpunkt eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS). Das Feld ist in den meisten Fällen verpflichtend, nur für die Status 'proposed', 'cancelled', 'waitlist' existiert kein Wert.

Begründung zu Kardinalität und Must Support: Die Kardinalität der slot-Eigenschaft bleibt 0..*, sodass ein Termin-Requestor bei der Terminbuchung nur einen Termin und ein Verweis auf ein ISiKKalender übergeben kann. Es ist dann die Aufgabe des Termin-Repositories in Abhängigkeit der gebuchten Dienstleistung freie Terminblöcke zu finden. Diese sind im Appointment zu referenzieren.

Hinweis: Im ISiK Kontext sollte dieses Feld zur internen Kommunikation zwischen Leistungserbringern verwendet werden, z.B. für interne Notizen rund um den Termin.

Begründung zum Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, zusätzliche Informationen zum Termin zu hinterlegen und abrufen zu können.

Es gilt weiterhin die Semantik des Elements nach FHIR-Kernspezifikation:

'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.'

Hinweis: Dieses Feld sollte im Kontext von ISIK verwendet werden für die Kommunikation im Sinne der Definition der FHIR-Kernspezifikation - sowohl von Systemseite (administrativ) als auch von Seiten des medizinischen Fachpersonals.

Beispiel für eine Nachricht: 'Bitte nüchtern erscheinen' etc.

Begründung zum Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, zusätzliche Informationen für Patienten zum Termin zu hinterlegen und abrufen zu können.

Es gilt weiterhin der Hinweis der FHIR Kernspezifikation: 'Note that FHIR strings SHALL NOT exceed 1MB in size'

Hinweis: Die Kardinalität von actor.display und das MS-Flag von .status wird an die Slices vererbt und diese sind entsprechend zu implementieren.

Begründung zu Kardinalität und Must Support: Die Teilnehmer eines Termins sind von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS).

Hinweis: Für alle Target-Ressourcen SOLL ein Displaywert für die Referenz angegeben werden, sodass Systeme eine Übersicht der am Termin beteiligten Akteure anzeigen können ohne die Referenzen auflösen zu müssen. Somit kann ein Termin-Consumer direkt anzeigen welche Akteure für den Termin relevant sind.

Hinweis: Im ISIK-Kontext MUSS der referenzierte Patient konform zum ISIKPatient des Basismoduls sein. Ein Sonderfall sind Patienten, über die ein Termin-Requestor oder Termin-Repository nur rudimentäre Informationen verfügt. Diese Patienten-Ressourcen sind bis zur Vervollständigung nur gegen den Kernstandard valide.

Begründung zu Kardinalität und Must Support: Die teilnehmenden Patienten eines Termins sind von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS). Hingegen kann die Patienten-Referenz separat in der $book-Operation übergeben werden, sodass hier keine verpflichtende Kardinaltiät gewählt werden kann.

​Im ISIK-Kontext MUSS die referenzierte RelatedPerson-Ressource konform zum ISiKAngehoeriger des Basismoduls sein.

Begründung zu Kardinalität und Must Support: Die Angabe eines Angehörigen ist optional, da in vielen Fällen die Referenzierung des Patienten ausreichend ist. Bei Terminen, die durch einen Angehörigen gebucht/verwaltet werden, ist es jedoch wichtig, dass diese Information an das Termin-Repository übermittelt werden kann.

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).

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

bedingtes Pflichtfeld/bedingtes MS: Alle von einem Server bereitgestellten Ressourcen MÜSSEN über eine id verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine idverfügen.

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.

Ein Tag kann verwendet werden um zu kennzeichnen, dass die Ressource von Extern erstellt worden ist.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über eine versionID verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über eine versionIDverfügen.

When the resource last changed - e.g. when the version changed.

Alle von einem Server bereitgestellten Ressourcen SOLLEN über ein lastUpdate verfügen. Von Clients erzeugte Ressourcen, die im Kontext einer CREATE-Interaktion übermittelt werden, MÜSSEN NICHT über ein lastUpdateverfügen.

A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

Security Labels from the Healthcare Privacy and Security Classification System.

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

A human language.

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

An Extension

Begründung zum Must Support: Termineabsagen sollten verkettbar sein, da am originalen Termin noch weitere Informationen hängen können.

An Extension

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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.

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).

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.

Begründung zu Must Support : Im ISiK Kontext ist der Status eines Termins von entscheidender Bedeutung, um den aktuellen Stand und die Verfügbarkeit des Termins zu kommunizieren.

The free/busy status of an appointment.

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.

Begründung zu Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, einen Grund für die Absage eines Termins zu hinterlegen.

A broad categorization of the service that is to be performed during this appointment.

The specific service that is to be performed during this appointment.

Begründung zu Kardinalität und Must Support: Die Dienstleistungsart eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher ist dieses Feld verpflichtend (1..*) und muss unterstützt werden (MS). Aufgrund der Heterogenität von Dienstleistungen ist eine standardisierte Kodierung nicht zwingend notwendig, eine Freitextbeschreibung ist ausreichend.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

A reference to a code defined by a terminology system.

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.

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

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.

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

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.

The specialty of a practitioner that would be required to perform the service requested in this appointment.

Optionale Angabe aller Fachbereiche aus denen ein oder mehrere Akteure für die Durchführung des Termins benötigt werden.

Begründung zu Kardinalität und Must Support: KANN auch anhand des Kalenders, in dem ein Termin gebucht wird, ermittelt werden. Die Angabe der Fachbereiche ist optional (0..*), muss jedoch implementiert werden (MS), um die Spezialisierung hinsichtlich der zugeordneten Behandlungseinheit des Termins eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

A reference to a code defined by a terminology system.

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.

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

A reference to a code defined by a terminology system.

Begründung zur Kardinalität: Die Kardinalität der Fachrichtung-Eigenschaft wird auf 1..1 festgelegt, um sicherzustellen, dass genau eine Fachrichtung vorhanden ist. Dies ist notwendig, um die Spezialisierung des Termins eindeutig zu definieren und eine korrekte Zuordnung zu gewährleisten.

Hintergrund zur Entscheidung: Die Wahl des hinterlegten ValueSets (http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode) wurde mit einem Mitglied der IHE Deutschland Arbeitsgruppe XDS ValueSets (https://www.ihe-d.de/projekte/xds-value-sets-fuer-deutschland/) sowie mit der KBV abgestimmt (Stand:13.6.2024).

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

A reference to a code defined by a terminology system.

Dieses ValueSet KANN über ein Mapping (siehe Abschnitt https://wiki.hl7.de/index.php?title=IG:Value_Sets_f%C3%BCr_XDS#DocumentEntry.practiceSettingCode) mit dem ValueSet der Fachrichtung verknüpft werden und darüber ggf. die Integration von Systemen erleichtern.

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

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.

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

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.

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

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

The Reason for the appointment to take place.

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.

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).

Begründung Must Support: Die Priorität eines Termins ist von entscheidender Bedeutung, um die Dringlichkeit und Relevanz des Termins zu kommunizieren und zu priorisieren. Eine Priorität ist nicht zwingend erforderlich, muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, die Dringlichkeit und Relevanz des Termins abzurufen.

unique id for the element within a resource (for internal references)

An Extension

Hinweis: In R5 ist die Priority ein CodeableConcept.

Begründung zu Must Support: Dieses Element ist optional (0..1), muss jedoch implementiert werden (MS), um besonders einen Notfall als solchen ausweisen zu können.

Optional Extension Element - found in all resources.

Primitive value for unsignedInt

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.

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

Date/Time that the appointment is to take place.

Begründung zu Kardinalität und Must Support: Der Startzeitpunkt eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS). Das Feld ist in den meisten Fällen verpflichtend, nur für die Status 'proposed', 'cancelled', 'waitlist' existiert kein Wert.

Date/Time that the appointment is to conclude.

Begründung zu Kardinalität und Must Support: Der Endzeitpunkt eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS). Das Feld ist in den meisten Fällen verpflichtend, nur für die Status 'proposed', 'cancelled', 'waitlist' existiert kein Wert.

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.

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

Begründung zu Kardinalität und Must Support: Die Kardinalität der slot-Eigenschaft bleibt 0..*, sodass ein Termin-Requestor bei der Terminbuchung nur einen Termin und ein Verweis auf ein ISiKKalender übergeben kann. Es ist dann die Aufgabe des Termin-Repositories in Abhängigkeit der gebuchten Dienstleistung freie Terminblöcke zu finden. Diese sind im Appointment zu referenzieren.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

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.

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.

Additional comments about the appointment.

Hinweis: Im ISiK Kontext sollte dieses Feld zur internen Kommunikation zwischen Leistungserbringern verwendet werden, z.B. für interne Notizen rund um den Termin.

Begründung zum Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, zusätzliche Informationen zum Termin zu hinterlegen und abrufen zu können.

Es gilt weiterhin die Semantik des Elements nach FHIR-Kernspezifikation:

'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.'

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).

Hinweis: Dieses Feld sollte im Kontext von ISIK verwendet werden für die Kommunikation im Sinne der Definition der FHIR-Kernspezifikation - sowohl von Systemseite (administrativ) als auch von Seiten des medizinischen Fachpersonals.

Beispiel für eine Nachricht: 'Bitte nüchtern erscheinen' etc.

Begründung zum Must Support: Dieses Feld ist optional (0..1), muss jedoch implementiert werden (MS), um die Möglichkeit zu bieten, zusätzliche Informationen für Patienten zum Termin zu hinterlegen und abrufen zu können.

Es gilt weiterhin der Hinweis der FHIR Kernspezifikation: 'Note that FHIR strings SHALL NOT exceed 1MB in size'

The service request this appointment is allocated to assess (e.g. incoming referral or procedure request).

List of participants involved in the appointment.

Hinweis: Die Kardinalität von actor.display und das MS-Flag von .status wird an die Slices vererbt und diese sind entsprechend zu implementieren.

Begründung zu Kardinalität und Must Support: Die Teilnehmer eines Termins sind von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher muss dieses Feld unterstützt werden (MS).

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

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).

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.

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.

Role of participant in the appointment.

The role of the participant can be used to declare what the actor will be doing in the scope of 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.

Role of participant in encounter.

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

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).