Implementierungsleitfaden ISiK-Terminplanung

ISiKTermin (Appointment)

Motivation

Das Datenobjekte ISiKTermin repräsentiert einen gebuchten Termin, sowie einen Terminvorschlag.

Kompatibilität

FHIR-Profil

Name	Canonical
ISiKTermin	https://gematik.de/fhir/isik/StructureDefinition/ISiKTermin

ISiKTermin (Appointment)	I		Appointment	Element id Appointment Short description 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) 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). Data type Appointment Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.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-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-6: A resource should have narrative for robust management text.`div`.exists() dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` 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')` 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-2: Either start and end are specified, or neither `start.exists() = end.exists()` ISiK-app-1: Der Endzeitpunkt eines Termins MUSS nach dem Startzeitpunkt liegen `start <= end` Mappings rim: Entity. Role, or Act workflow: Request rim: Act[@moodCode <= 'INT'] ical: VEVENT
id	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. 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. Data type string
meta	S Σ	0..1	Meta	Element id Appointment.meta Short description Metadata about the resource 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. Comments Ein Tag kann verwendet werden um zu kennzeichnen, dass die Ressource von Extern erstellt worden ist. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
id		0..1	string	There are no (further) constraints on this element Element id Appointment.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
versionId	Σ	0..1	id	There are no (further) constraints on this element Element id Appointment.meta.versionId Short description Version specific identifier Definition 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. Comments The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
lastUpdated	Σ	0..1	instant	There are no (further) constraints on this element Element id Appointment.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
source	Σ	0..1	uri	There are no (further) constraints on this element Element id Appointment.meta.source Short description Identifies where the resource comes from Definition 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. Comments 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
profile	Σ	0..*	canonical(StructureDefinition)	There are no (further) constraints on this element Element id Appointment.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments 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. Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
security	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id Appointment.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments 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. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
tag	S Σ	0..*	Coding	Element id Appointment.meta.tag Short description Tags applied to this resource Definition 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. Comments 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. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
Source	S Σ	0..1	CodingBinding	Element id Appointment.meta.tag:Source Short description Tags applied to this resource Definition 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. Comments 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. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". VS_CommonMetaTag_De (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id Appointment.implicitRules Short description A set of rules under which this content was created 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. 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. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
language		0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.language Short description Language of the resource content Definition The base language in which the resource is written. 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). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
text		0..1	Narrative	There are no (further) constraints on this element Element id Appointment.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display 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. 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. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id Appointment.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources 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. 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. Data type Resource Mappings rim: Entity. Role, or Act rim: N/A
extension	S I	0..*	Extension	Element id Appointment.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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. Comments Begründung zum Must Support: Termineabsagen sollten verkettbar sein, da am originalen Termin noch weitere Informationen hängen können. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
Nachricht	S I	0..*	Extension(Reference(ISiKNachricht))	Element id Appointment.extension:Nachricht Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data type Extension(Reference(ISiKNachricht)) Extension URL https://gematik.de/fhir/isik/StructureDefinition/ISiKNachrichtExtension Constraints ele-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()` Mappings rim: n/a rim: N/A
replaces	S I	0..1	Extension(Reference(Appointment))	Element id Appointment.extension:replaces Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data type Extension(Reference(Appointment)) Extension URL http://hl7.org/fhir/5.0/StructureDefinition/extension-Appointment.replaces Constraints ele-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()` Mappings rim: n/a rim: N/A
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content 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). 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
identifier	Σ	0..*	Identifier	There are no (further) constraints on this element Element id Appointment.identifier Short description External Ids for this item 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier workflow: Request.identifier w5: FiveWs.identifier v2: SCH-1, SCH-2, ARQ-1, ARQ-2 rim: .id ical: UID
status	S Σ ?!	1..1	codeBinding	Element id Appointment.status Short description proposed \| pending \| booked \| arrived \| fulfilled \| cancelled \| noshow \| entered-in-error \| checked-in \| waitlist Definition 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. Comments 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. Data type code Binding The free/busy status of an appointment. AppointmentStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.status w5: FiveWs.status v2: SCH-25 rim: .statusCode ical: STATUS
cancelationReason	S Σ	0..1	CodeableConceptBinding	Element id Appointment.cancelationReason Short description The coded reason for the appointment being cancelled 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. Comments 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. Data type CodeableConcept Binding ISiKTerminCancelationReason (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
serviceCategory	Σ	0..*	CodeableConcept	There are no (further) constraints on this element Element id Appointment.serviceCategory Short description A broad categorization of the service that is to be performed during this appointment Definition A broad categorization of the service that is to be performed during this appointment. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding ServiceCategory (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD rim: n/a, might be inferred from the ServiceDeliveryLocation ical: CATEGORIES
serviceType	S Σ	1..*	CodeableConcept	Element id Appointment.serviceType Short description The specific service that is to be performed during this appointment Definition The specific service that is to be performed during this appointment. Comments 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. Data type* CodeableConcept Binding ServiceType (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.code rim: n/a, might be inferred from the ServiceDeliveryLocation
id		0..1	string	There are no (further) constraints on this element Element id Appointment.serviceType.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.serviceType.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
coding	Σ	0..*	Coding	There are no (further) constraints on this element Element id Appointment.serviceType.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. 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. Data type Coding Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	S Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.serviceType.text Short description Plain text representation of the concept 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. 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
specialty	S Σ	0..*	CodeableConceptBinding	Element id Appointment.specialty Short description The specialty of a practitioner that would be required to perform the service requested in this appointment Definition The specialty of a practitioner that would be required to perform the service requested in this appointment. Comments 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. Data type* CodeableConcept Binding PracticeSettingCodeValueSet (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD w5: FiveWs.class rim: .performer.AssignedPerson.code
id		0..1	string	There are no (further) constraints on this element Element id Appointment.specialty.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.specialty.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
coding	S Σ	1..*	Coding	Element id Appointment.specialty.coding Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. 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. Data type Coding Sliced: Unordered, Open, by $this(Pattern) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
Fachrichtung	S Σ	1..1	CodingBinding	Element id Appointment.specialty.coding:Fachrichtung Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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). Data type Coding Binding IHEXDSpracticeSettingCode (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
ErweiterterFachabteilungsschluessel	Σ	0..1	CodingBinding	Element id Appointment.specialty.coding:ErweiterterFachabteilungsschluessel Short description Code defined by a terminology system Definition A reference to a code defined by a terminology system. Requirements Allows for alternative encodings within a code system, and translations to other code systems. Comments 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. Data type Coding Binding ValueSetFachabteilungsschluesselErweitert (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6 rim: CV orim: fhir:Coding rdfs:subClassOf dt:CDCoding v2: CE.1-8, CE.10-22 rim: union(., ./translation) orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
text	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.specialty.text Short description Plain text representation of the concept 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. 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. Comments Very often the text is the same as a displayName of one of the codings. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE.9. But note many systems use CE.2 for this rim: ./originalText[mediaType/code="text/plain"]/data orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
appointmentType	Σ	0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.appointmentType Short description The style of appointment or patient that has been booked in the slot (not service type) Definition The style of appointment or patient that has been booked in the slot (not service type). Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding v2.0276 (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: ARQ-7 rim: .code ical: CLASSIFICATION
reasonCode	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.reasonCode Short description Coded reason this appointment is scheduled Definition The coded reason that this appointment is being scheduled. This is more clinical than administrative. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding The Reason for the appointment to take place. EncounterReasonCodes (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD workflow: Request.reasonCode v2: AIS-3, SCH-7 rim: .reasonCode
reasonReference	I	0..*	Reference(Condition \| Procedure \| Observation \| ImmunizationRecommendation)	There are no (further) constraints on this element Element id Appointment.reasonReference Short description Reason the appointment is to take place (resource) 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. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Condition \| Procedure \| Observation \| ImmunizationRecommendation) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.reasonReference rim: .inboundRelationship[@typeCode = 'RSON'].observation
priority	S	0..1	unsignedInt	Element id Appointment.priority Short description Used to make informed decisions if needing to re-prioritize 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). Comments 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. Data type unsignedInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.priority w5: FiveWs.class v2: ARQ-12, SCH-11.6 / TQ1-9 rim: .priorityCode ical: PRIORITY
id		0..1	string	There are no (further) constraints on this element Element id Appointment.priority.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	S I	0..*	Extension	Element id Appointment.priority.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
Priority	S I	0..1	Extension(CodeableConcept)	Element id Appointment.priority.extension:Priority Short description Optional Extensions Element Alternate names extensions, user content Definition Optional Extension Element - found in all resources. 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. Data type Extension(CodeableConcept) Extension URL https://gematik.de/fhir/isik/StructureDefinition/ISiKTerminPriorityExtension Constraints ele-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()` Mappings rim: n/a rim: N/A
value		0..1	System.String	There are no (further) constraints on this element Element id Appointment.priority.value Short description Primitive value for unsignedInt Definition Primitive value for unsignedInt Data type System.String Minimum value -2147483648 Maximum value 2147483647
description		0..1	string	There are no (further) constraints on this element Element id Appointment.description Short description Shown on a subject line in a meeting request, or appointment list 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: NTE-3 rim: .text ical: SUMMARY
supportingInformation	I	0..*	Reference(Resource)	There are no (further) constraints on this element Element id Appointment.supportingInformation Short description Additional information to support the appointment Definition Additional information to support the appointment provided when making the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.supportingInfo w5: FiveWs.context rim: .inboundRelationship[@typeCode = 'SPRT'].observation ical: ATTACH
start	S Σ	1..1	instant	Element id Appointment.start Short description When appointment is to take place Definition Date/Time that the appointment is to take place. Comments Begründung zu Kardinalität und Must Support: Der Startzeitpunkt eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher ist dieses Feld verpflichtend (1..1) und muss unterstützt werden (MS). Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.init v2: ARQ-11.1, SCH-11.4 / TQ1-7 rim: .effectiveTime.low ical: DTSTART
end	S Σ	1..1	instant	Element id Appointment.end Short description When appointment is to conclude Definition Date/Time that the appointment is to conclude. Comments Begründung zu Kardinalität und Must Support: Der Endzeitpunkt eines Termins ist von entscheidender Bedeutung, um die Verfügbarkeit und Planung des Termins zu gewährleisten. Daher ist dieses Feld verpflichtend (1..1) und muss unterstützt werden (MS). Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] w5: FiveWs.done[x] v2: SCH-11.5 / TQ1-8/ calculated based on the start and the duration which is in ARQ-9 rim: .effectiveTime.high ical: DTEND
minutesDuration		0..1	positiveInt	There are no (further) constraints on this element Element id Appointment.minutesDuration Short description Can be less than start/end (e.g. estimate) 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. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.occurrence[x] rim: .activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')].width ical: DURATION (e.g. PT15M)
slot	S I	0..*	Reference(Slot)	Element id Appointment.slot Short description The slots that this appointment is filling Definition The slots from the participants' schedules that will be filled by the appointment. Comments 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. Data type* Reference(Slot) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) rim: .outboundRelationship[@typeCode = 'REFR'].act[@classCode = 'ACT'][@moodCode = 'SLOT']
id		0..1	string	There are no (further) constraints on this element Element id Appointment.slot.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.slot.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id Appointment.slot.reference Short description Literal reference, Relative, internal or absolute URL Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Appointment.slot.type Short description Type the reference refers to (e.g. "Patient") Definition 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Appointment.slot.identifier Short description Logical reference, when literal reference is not known Definition 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.slot.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
created		0..1	dateTime	There are no (further) constraints on this element Element id Appointment.created Short description The date that this appointment was initially 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. 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. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.authoredOn rim: .author.time ical: CREATED
comment	S	0..1	string	Element id Appointment.comment Short description Additional comments Definition Additional comments about the appointment. Comments 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.' Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a workflow: Request.note v2: NTE-3 rim: .subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value ical: DESCRIPTION (for internal use)
patientInstruction	S	0..1	string	Element id Appointment.patientInstruction Short description Detailed information and instructions for the patient Definition 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). Comments 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' Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: NTE-3 rim: .subjectOf.observation[@moodCode = 'EVN'][code = 'annotation'].value ical: DESCRIPTION (for patient use)
basedOn	I	0..*	Reference(ServiceRequest)	There are no (further) constraints on this element Element id Appointment.basedOn Short description The service request this appointment is allocated to assess Alternate names incomingReferral Definition The service request this appointment is allocated to assess (e.g. incoming referral or procedure request). Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(ServiceRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) workflow: Request.basedOn rim: .outboundRelationship[@typeCode = 'FLFS'].act[@classCode < 'ActCareProvisionRequestType'][@moodCode = 'RQO']
participant	S I	1..*	BackboneElement	Element id Appointment.participant Short description Participants involved in appointment Definition List of participants involved in the appointment. Comments 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). Data type BackboneElement Sliced: Unordered, Open, by actor.resolve()(Type) Constraints 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()` Mappings rim: n/a workflow: Request.performer, Request.subject v2: PID, AIP, AIG, AIL rim: performer \| reusableDevice \| subject \| location ical: ATTENDEE component to be created
(All Slices)				There are no (further) constraints on this element
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints ele-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()` Mappings rim: n/a rim: N/A
type	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.participant.type Short description Role of participant in the appointment Definition Role 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. Data type CodeableConcept Binding Role of participant in encounter. ParticipantType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: AIP-4, AIG-4 rim: (performer \| reusableDevice \| subject \| location).@typeCode ical: n/a
actor	S Σ I	1..1	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Device \| HealthcareService \| Location)	There are no (further) constraints on this element Element id Appointment.participant.actor Short description Person, Location/HealthcareService or Device Definition A Person, Location/HealthcareService or Device that is participating in the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Device \| HealthcareService \| Location) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.who v2: PID-3-Patient ID List \| AIL-3 \| AIG-3 \| AIP-3 rim: performer.person \| reusableDevice.manufacturedDevice \| subject.patient \| location.serviceDeliveryLocation ical: ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant.actor.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant.actor.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
reference	Σ I	0..1	string	There are no (further) constraints on this element Element id Appointment.participant.actor.reference Short description Literal reference, Relative, internal or absolute URL Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Appointment.participant.actor.type Short description Type the reference refers to (e.g. "Patient") Definition 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Appointment.participant.actor.identifier Short description Logical reference, when literal reference is not known Definition 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
display	S Σ	0..1	string	Element id Appointment.participant.actor.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
required	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant.required Short description required \| optional \| information-only 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Is the Participant required to attend the appointment. ParticipantRequired (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: (performer \| reusableDevice \| subject \| location).@performInd ical: ROLE=REQ-PARTICIPANT (roleparam)
status	S Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant.status Short description accepted \| declined \| tentative \| needs-action Definition Participation status of the actor. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The Participation status of an appointment. ParticipationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: AIP-12, AIG-14 rim: (performer \| reusableDevice \| subject \| location).statusCode ical: ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam \| partstatparam)
period	I	0..1	Period	There are no (further) constraints on this element Element id Appointment.participant.period Short description Participation period of the actor Definition Participation period of the actor. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
AkteurPatient	S I	1..*	BackboneElement	Element id Appointment.participant:AkteurPatient Short description Participants involved in appointment Definition List of participants involved in the appointment. Comments Hinweis: Im ISIK-Kontext MUSS der referenzierte Patient konform zum ISIKPatient des Basismoduls sein. 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 ist dieses Feld verpflichtend (1..) und muss unterstützt werden (MS). Data type* BackboneElement Constraints 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()` Mappings rim: n/a workflow: Request.performer, Request.subject v2: PID, AIP, AIG, AIL rim: performer \| reusableDevice \| subject \| location ical: ATTENDEE component to be created
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints ele-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()` Mappings rim: n/a rim: N/A
type	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.type Short description Role of participant in the appointment Definition Role 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. Data type CodeableConcept Binding Role of participant in encounter. ParticipantType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: AIP-4, AIG-4 rim: (performer \| reusableDevice \| subject \| location).@typeCode ical: n/a
actor	Σ I	0..1	Reference(Patient)	Element id Appointment.participant:AkteurPatient.actor Short description Person, Location/HealthcareService or Device Definition A Person, Location/HealthcareService or Device that is participating in the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Patient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.who v2: PID-3-Patient ID List \| AIL-3 \| AIG-3 \| AIP-3 rim: performer.person \| reusableDevice.manufacturedDevice \| subject.patient \| location.serviceDeliveryLocation ical: ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.actor.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.actor.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.actor.reference Short description Literal reference, Relative, internal or absolute URL Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.actor.type Short description Type the reference refers to (e.g. "Patient") Definition 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.actor.identifier Short description Logical reference, when literal reference is not known Definition 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.actor.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
required	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.required Short description required \| optional \| information-only 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Is the Participant required to attend the appointment. ParticipantRequired (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: (performer \| reusableDevice \| subject \| location).@performInd ical: ROLE=REQ-PARTICIPANT (roleparam)
status	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.status Short description accepted \| declined \| tentative \| needs-action Definition Participation status of the actor. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The Participation status of an appointment. ParticipationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: AIP-12, AIG-14 rim: (performer \| reusableDevice \| subject \| location).statusCode ical: ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam \| partstatparam)
period	I	0..1	Period	There are no (further) constraints on this element Element id Appointment.participant:AkteurPatient.period Short description Participation period of the actor Definition Participation period of the actor. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
AkteurPersonImGesundheitsberuf	S I	0..*	BackboneElement	Element id Appointment.participant:AkteurPersonImGesundheitsberuf Short description Participants involved in appointment Definition List of participants involved in the appointment. Comments Im ISIK-Kontext MUSS die referenzierte Practitioner-Ressource konform zum ISiKPersonImGesundheitsberuf des Basismoduls sein. Begründung zu Kardinalität und Must Support: Die teilnehmenden Personen mit einem Gesundheitsberuf eines Termins sind entscheidend und müssen daher implementiert werden (MS), allerdings sind sie nicht zwingend erforderlich (0..), da die Übernahme auch durch eine Behandlungseinheit erfolgen kann. Data type* BackboneElement Constraints 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()` Mappings rim: n/a workflow: Request.performer, Request.subject v2: PID, AIP, AIG, AIL rim: performer \| reusableDevice \| subject \| location ical: ATTENDEE component to be created
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints ele-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()` Mappings rim: n/a rim: N/A
type	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.type Short description Role of participant in the appointment Definition Role 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. Data type CodeableConcept Binding Role of participant in encounter. ParticipantType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: AIP-4, AIG-4 rim: (performer \| reusableDevice \| subject \| location).@typeCode ical: n/a
actor	Σ I	0..1	Reference(Practitioner)	Element id Appointment.participant:AkteurPersonImGesundheitsberuf.actor Short description Person, Location/HealthcareService or Device Definition A Person, Location/HealthcareService or Device that is participating in the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(Practitioner) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.who v2: PID-3-Patient ID List \| AIL-3 \| AIG-3 \| AIP-3 rim: performer.person \| reusableDevice.manufacturedDevice \| subject.patient \| location.serviceDeliveryLocation ical: ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.actor.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.actor.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.actor.reference Short description Literal reference, Relative, internal or absolute URL Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.actor.type Short description Type the reference refers to (e.g. "Patient") Definition 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.actor.identifier Short description Logical reference, when literal reference is not known Definition 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.actor.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
required	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.required Short description required \| optional \| information-only 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Is the Participant required to attend the appointment. ParticipantRequired (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: (performer \| reusableDevice \| subject \| location).@performInd ical: ROLE=REQ-PARTICIPANT (roleparam)
status	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.status Short description accepted \| declined \| tentative \| needs-action Definition Participation status of the actor. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The Participation status of an appointment. ParticipationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: AIP-12, AIG-14 rim: (performer \| reusableDevice \| subject \| location).statusCode ical: ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam \| partstatparam)
period	I	0..1	Period	There are no (further) constraints on this element Element id Appointment.participant:AkteurPersonImGesundheitsberuf.period Short description Participation period of the actor Definition Participation period of the actor. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
AkteurMedizinischeBehandlungseinheit	S I	0..*	BackboneElement	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit Short description Participants involved in appointment Definition List of participants involved in the appointment. Data type BackboneElement Constraints 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()` Mappings rim: n/a workflow: Request.performer, Request.subject v2: PID, AIP, AIG, AIL rim: performer \| reusableDevice \| subject \| location ical: ATTENDEE component to be created
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints ele-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()` Mappings rim: n/a rim: N/A
type	Σ	0..*	CodeableConceptBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.type Short description Role of participant in the appointment Definition Role 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. Data type CodeableConcept Binding Role of participant in encounter. ParticipantType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD v2: AIP-4, AIG-4 rim: (performer \| reusableDevice \| subject \| location).@typeCode ical: n/a
actor	Σ I	0..1	Reference(HealthcareService)	Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor Short description Person, Location/HealthcareService or Device Definition A Person, Location/HealthcareService or Device that is participating in the appointment. Comments References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Data type Reference(HealthcareService) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ref-1: SHALL have a contained resource if a local reference is provided `reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))` Mappings rim: n/a rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity) w5: FiveWs.who v2: PID-3-Patient ID List \| AIL-3 \| AIG-3 \| AIP-3 rim: performer.person \| reusableDevice.manufacturedDevice \| subject.patient \| location.serviceDeliveryLocation ical: ATTENDEE: (Need to provide the common name CN and also the MAILTO properties from the practitioner resource) where the participant type is not "information-only"
id		0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-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()` Mappings rim: n/a rim: N/A
reference	S Σ I	1..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor.reference Short description Literal reference, Relative, internal or absolute URL Definition 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. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
type	Σ	0..1	uriBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor.type Short description Type the reference refers to (e.g. "Patient") Definition 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). Comments 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. Data type uri Binding Aa resource (or, for logical models, the URI of the logical model). ResourceType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
identifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor.identifier Short description Logical reference, when literal reference is not known Definition 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. Comments 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). Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CX / EI (occasionally, more often EI maps to a resource id or a URL) rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT] servd: Identifier rim: .identifier
display	Σ	0..1	string	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor.display Short description Text alternative for the resource Definition Plain text narrative that identifies the resource in addition to the resource reference. Comments 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. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: N/A
required	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.required Short description required \| optional \| information-only 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. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding Is the Participant required to attend the appointment. ParticipantRequired (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a rim: (performer \| reusableDevice \| subject \| location).@performInd ical: ROLE=REQ-PARTICIPANT (roleparam)
status	Σ	1..1	codeBinding	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.status Short description accepted \| declined \| tentative \| needs-action Definition Participation status of the actor. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type code Binding The Participation status of an appointment. ParticipationStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: AIP-12, AIG-14 rim: (performer \| reusableDevice \| subject \| location).statusCode ical: ATTENDEE;CN="John Doe";RSVP=TRUE:mailto:john@doe.com (rsvpparam \| partstatparam)
period	I	0..1	Period	There are no (further) constraints on this element Element id Appointment.participant:AkteurMedizinischeBehandlungseinheit.period Short description Participation period of the actor Definition Participation period of the actor. Comments A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
requestedPeriod	I	0..*	Period	There are no (further) constraints on this element Element id Appointment.requestedPeriod Short description Potential date/time interval(s) requested to allocate the appointment within Definition 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. Comments This does not introduce a capacity for recurring appointments. Data type Period Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` per-1: If present, start SHALL have a lower value than end `start.hasValue().not() or end.hasValue().not() or (start <= end)` Mappings rim: n/a v2: DR rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"] workflow: Request.occurrence[x] v2: ARQ-11 rim: .activityTime[@xsi:type = ('SXPR_TS', 'PIVL_TS')]

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

Folgende FHIRPath-Constraints sind im Profil zu beachten:

key	severity	human	expression
ISiK-app-1	error	Der Endzeitpunkt eines Termins MUSS nach dem Startzeitpunkt liegen	start <= end

Terminology Bindings

Path	Name	Strength	URL
Appointment.meta.tag	common-meta-tag-de	required	http://fhir.de/ValueSet/common-meta-tag-de
Appointment.cancelationReason	ISiKTerminCancelationReason	required	https://gematik.de/fhir/isik/ValueSet/ISiKTerminCancelationReason
Appointment.specialty.coding	he-d.de/ValueSets/IHEXDSpracticeSettingCode	required	http://ihe-d.de/ValueSets/IHEXDSpracticeSettingCode
Appointment.specialty.coding	dkgev/Fachabteilungsschluessel-erweitert	required	http://fhir.de/ValueSet/dkgev/Fachabteilungsschluessel-erweitert

Anmerkungen zu Must-Support-Feldern

`Appointment.meta.tag`

Bedeutung: Herkunft der Termins

Hinweis: Angabe, ob der Termin durch einen externen Termin Requestor eingestellt wurde. Falls das Datenobjekt dauerhaft in das Termin Repository gespeichert wird, KANN der Tag entfernt werden. Für die weitere Prozesssteuerung kann eine Unterscheidung, ob es sich um einen intern oder extern erstellten Termin handelt, notwendig sein, sodass aus Gründen der Nachvollziehbarkeit der Tag bestehen bleiben sollte. Des Weiteren gelten die Vorgaben des ISiK Basismoduls zur CREATE-Interaktion.

`Appointment.extension:Nachricht`

Bedeutung: Kommunikation mit dem Patienten

Hinweis: Für die Kommunikation mit dem Patienten sind Communication-Ressourcen zu verwenden. Für den Termin relevante Kommentare oder Anhänge MÜSSEN angegeben werden. Zudem kann die Communication-Ressource auch für die Kommunikation zwischen Leistungserbringer verwendet werden. Es ist zu beachten, dass in diesem Fall Kommentare vor der Herausgabe an die Patient:in gefiltert werden sollten.

`Appointment.extension:replaces`

Bedeutung: Angabe eines abgesagten / verschobenen Termins

Hinweis: Im Falle, dass per $book-Operation ein verschobener / abgesagter Termin angegeben wird, MUSS dieser für die Rückverfolgbarkeit referenziert werden.

`Appointment.status`

Bedeutung: Differenzierung zwischen Terminwunsch und gebuchten Termin

Hinweis: Ein Termin Requestor kann im Status entsprechend wählen, sodass der Termin als Terminwunsch zu interpretieren ist. Nachdem der Termin bestätigt wurde, ist der Terminstatus durch das Termin-Repository anzupassen.

Alle Statuswerte MÜSSEN durch ein bestätigungsrelevantes System unterstützt werden, insbesondere der Status "proposed" und "booked".

`Appointment.cancelationReason`

Bedeutung: Grund für die Absage eines Termins

Hinweis: Eine minimale Kodierung MUSS mittels des vorgeschlagenen Bindings vorliegen. Differenzierungen mit feinerer Granularität können durch weitere Codings erfolgen.

`Appointment.serviceType`

Bedeutung: Kodierung der Behandlungsleistung des Termins

Hinweis: Dies SOLL der Kodierung des serviceType eines Schedules entsprechen, der innerhalb des Termins gebucht wird. Ein Termin-Repository SOLL einen Termin abweisen, falls unbekannte Kodierungen in .serviceType durch den Termin-Requestor übermittelt werden, sodass ein Termin-Repository sicherstellen kann, dass alle Ressourcen für die Behandlungsleistung(en) bereitgestellt werden können. Hierzu ist eine Interpretation der Behandlungsleistung notwendig. Ein Termin KANN für mehrere Behandlungsleistungen gebucht werden, falls dies durch die Fachlogik des Termin-Repositories unterstüzt wird.

`Appointment.specialty`

Bedeutung: Kodierung der Fachrichtung des Termins

Hinweis: Sofern aus den auf der Appointment-Ressource aufsetzenden Anwendungsfällen eine weitere Verarbeitung der Ressource durch einen menschlichen Nutzer nicht ausgeschlossen werden kann, MUSS das bestätigungsrelevante System mit dem Termin verbundenen Ressourcen (insb. Appointment.slot, Appointment.slot.schedule, Appointment.participant:AkteurMedizinischeBehandlungseinheit.actor) oder aus dem spezifischen Kontext verfügbare Informationen auswerten und das Element Appointment.specialty mit einem sinnvollen Wert kodieren (eine Ausnahme bildet hier zum Beispiel die fachrichtungs-unabhängige Terminplanung durch krankenhausinterne, zentrale Organisationseinheiten). Insbesondere ist die Kodierung der Fachrichtung des Termins notwendig im Kontext der Bereitstellung einer graphischen Oberfläche, wie sie Endnutzenden in einem Zuweiserportal/Patientenportal zur Ansicht gebracht wird.

`Appointment.priority.extension:Priority`

Bedeutung: Kodierte Angabe der Priorität des Termins

Hinweis: Anstelle der numerischen Priorität MUSS in ISiK eine kodierte Priorität angegeben werden.

`Appointment.start`

Bedeutung: Startzeitpunkt des Termins

Hinweis: Sofern der Termin an einen Slot gebunden ist, SOLL der Startzeitpunkt des Termins dem Startzeitpunkt des ersten Slots des Termins entsprechen.

`Appointment.end`

Bedeutung: Endzeitpunkt des Termins

Hinweis: Sofern der Termin an einen Slot gebunden ist, SOLL der Endzeitpunkt des Termins dem Endzeitpunkt des letzten Slots des Termins entsprechen.

`Appointment.slot`

Bedeutung: Referenzierung der Slots für die Verknüpfung des Termins mit einem Schedule

Hinweis: Die Referenzierung des Schedules kann durch einen oder mehrere Slots erfolgen. Es kann keine Reihenfolge durch die Angabe der Slots abgeleitet werden.

Hinweis: In der Vergangenheit liegende Slots, welche nicht verknüpft wurden, dürfen nicht mehr abrufbar sein. Jegliche andere Slots müssen auch per id, herausgegeben werden. Sobald die id einmalig per Search herausgeben wurde, müssen diese gleichbleibend abrufbar sein.

`Appointment.patientInstruction`

Bedeutung: Handlungsanweisungen für die Patienten in Vorbereitung auf den Termin

`Appointment.participant`

Bedeutung: Teilnehmer des Termins

Hinweis: Mindestens eine Patient-Referenz MUSS angegeben werden. Dies MUSS durch das Termin-Repository während der Buchung des Termins geprüft werden. Weitere Leistungserbringer KÖNNEN angegeben werden.

Interaktionen

Für die Ressource Appointment MÜSSEN die REST-Interaktionen "READ" und "PATCH" implementiert werden.

Der Suchparameter "_id" MUSS unterstützt werden:

Beispiele:

GET [base]/Appointment?_id=103270

Anwendungshinweise: Weitere Informationen zur Suche nach "_id" finden sich in der FHIR-Basisspezifikation - Abschnitt "Parameters for all resources".
Der Suchparameter "status" MUSS unterstützt werden:

Beispiele:

GET [base]/Appointment?status=booked

Anwendungshinweise: Weitere Informationen zur Suche nach "Appointment.status" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "service-type" MUSS unterstützt werden:

Beispiele:

GET [base]/Appointment?service-type=http://example.org/fhir/CodeSystem/ScheduleServiceType|CT

Anwendungshinweise: Weitere Informationen zur Suche nach "Appointment.serviceType" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "specialty" MUSS unterstützt werden:

Beispiele:

GET [base]/Appointment?specialty=urn:oid:1.2.276.0.76.5.114|535

Anwendungshinweise: Weitere Informationen zur Suche nach "Appointment.specialty" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "date" MUSS unterstützt werden:

Beispiele:

GET [base]/Appointment?date=2022-12-10T09:00:00Z

Anwendungshinweise: Die Suche wird gegen das Element "Appointment.start" ausgewertet. Weitere Informationen zur Suche nach "Appointment.start" finden sich in der FHIR-Basisspezifikation - Abschnitt "Date Search".
Der Suchparameter "slot" MUSS unterstützt werden:

Beispiele:

GET [base]/Appointment?slot=Slot/ISiKSlotExample

Anwendungshinweise: Weitere Informationen zur Suche nach "Appointment.slot" finden sich in der FHIR-Basisspezifikation - Abschnitt "reference".
Der Suchparameter "actor" MUSS unterstützt werden:

Beispiele:

GET [base]/Appointment?actor=Patient/ISiKPatientExample

Anwendungshinweise: Weitere Informationen zur Suche nach "Appointment.participant.actor" finden sich in der FHIR-Basisspezifikation - Abschnitt "reference".

Beispiele

{
    "resourceType": "Appointment",
    "id": "ISiKTerminExample",
    "meta": {
        "tag":  [
            {
                "code": "external",
                "system": "http://fhir.de/CodeSystem/common-meta-tag-de"
            }
        ],
        "profile":  [
            "https://gematik.de/fhir/isik/StructureDefinition/ISiKTermin"
        ]
    },
    "extension":  [
        {
            "url": "https://gematik.de/fhir/isik/StructureDefinition/ISiKNachrichtExtension",
            "valueReference": {
                "reference": "Communication/ISiKNachrichtExample"
            }
        }
    ],
    "status": "proposed",
    "start": "2022-12-10T09:00:00Z",
    "end": "2022-12-10T11:00:00Z",
    "slot":  [
        {
            "reference": "Slot/ISiKTerminblockExample"
        }
    ],
    "serviceType":  [
        {
            "coding":  [
                {
                    "code": "124",
                    "system": "http://terminology.hl7.org/CodeSystem/service-type"
                }
            ]
        }
    ],
    "specialty":  [
        {
            "coding":  [
                {
                    "code": "ALLG",
                    "system": "http://ihe-d.de/CodeSystems/AerztlicheFachrichtungen"
                }
            ]
        }
    ],
    "participant":  [
        {
            "actor": {
                "display": "Test Patient",
                "reference": "Patient/example"
            },
            "status": "accepted"
        }
    ],
    "_priority": {
        "extension":  [
            {
                "url": "https://gematik.de/fhir/isik/StructureDefinition/ISiKTerminPriorityExtension",
                "valueCodeableConcept": {
                    "coding":  [
                        {
                            "code": "25876001",
                            "system": "http://snomed.info/sct"
                        }
                    ]
                }
            }
        ]
    }
}