Appointment Management

Information

See: Core FHIR Resources Appointment, Schedule, Slot

Todo: Oridashi Profiles for Appointment, Schedule and Slot

Available Slots

• Schedules (Appointment Book) can be retrieved from FHIR interface (FHIR Schedule)
• Each FHIR Schedule is for a provider (FHIR Practitioner); there may be multiple sessions per day
• A FHIR extension defines the nominal slot period length for each Schedule
• Free/Busy slots are available (FHIR Slot)
• Configurable look ahead period (default 6 weeks)
• Polling to detect schedule changes

For appointment book practice adapter calls Oridashi-Hiasobi FHIR API search request:

GET [base]/Schedule?date=<date>&actor=<practitioner id>&_include=Schedule:actor

Oridashi-Hiasobi FHIR API search response:

• Return a FHIR Bundle
• Bundle.entry will contain Schedule and included (actor) Practitioner and Location resources
• Example response in xml + json format:

schedule-xml schedule-json

For free/busy slots practice adapter calls Oridashi-Hiasobi FHIR API search request:

GET [base]/Slot?schedule=<schedule.id>

Oridashi-Hiasobi FHIR API search response:

• Return a FHIR Bundle
• Bundle.entry will contain Slot entries
• Example response in xml + json format:

slot-xml slot-json

• Responses (Schedule, Slot + referred to Practitioner, Location) are combined into a FHIR Bundle and submitted to cloud endpoint
• Example submission in xml + json format:

submit-xml submit-json

Cloud endpoint FHIR API transaction submission; body is FHIR Bundle assembled as above

POST [base]

• Cloud system can update schedules, slots

Appointments Requiring Action

• Practice components search for requested/cancelled appointments from a cloud endpoint
• Search by:
  • Appointment.status=pending - are requests that are not confirmed yet (indicates a request)
  • Appointement.location.identifier - identifies the practice associated with the appointment request

Cloud endpoint FHIR API search request:

GET [base]/Appointment?status=pending&location.identifier=<siteid>&_include=Appointment:actor

Cloud endpoint FHIR API search response:

• Return a FHIR Bundle
• Bundle.entry will contain Appointment and included (actor) Practitioner, Patient and Location resources
• Example response in xml + json format:

example-appointment-request-xml example-appointment-request-json

• Appointment indicating a request structured like:

Appointment
 status=pending - indicates appointment needs attention
 description - optional comment text (will be shown in the PMS)
 start - expected visit start date/time
 end - expected visit end date/time
 slot - optional reference to a free/busy Slot resource
 comment - optional comment text (will be shown in the PMS)
 participant [0] - participant practitioner
   type=PPRF|http://hl7.org/fhir/v3/ParticipationType - coded participation (primary performer is the attending clinician) 
   actor is Practitioner - reference to Practitioner  (FHIR internal identifier) 
   required=required - coded indicates this participation in the appointment is needed
   status=needs-action - coded indicates the participation is not confirmed
 participant [1]
   type = null
   actor is Patient - reference to Patient (FHIR internal identifier) 
   required=required - coded indicates this participation in the appointment is needed
   status=accepted - coded indicates the patient intends to attend
 participant [2] 
   type = null
   actor is Location - reference to Location (FHIR internal identifier) 
   required=required- coded indicates this participation in the appointment is needed
   status=needs-action - coded indicates the participation is not confirmed

Appointment Accept/Reject

• Appointment requests retrieved from the cloud are processed
  • Patient matching can occur based on Name, Date of Birth, Gender (or other identifying information)
  • Provider matching can occur based on Name, Provider Number (or other identifying information)
• Submitted appointment will be as per appointment request obtained from cloud endpoint

• Practice adapter will create/update appointments on matching
  • Appointments are attempted to be made in the PMS
  • Result will be accepted or declined appointment allocation

FHIR add/update appointment using Oridashi-Hiasobi interface

PUT [base]/Appointment/<id>

FHIR add/update response (accept)

Appointment
 status=booked - indicates appointment has been made in PMS
 start - scheduled visit start date/time
 end - scheduled visit end date/time
 slot - optional reference to a free/busy Slot resource
 comment - optional comment text (will be shown in the PMS)
 participant [0] - participant practitioner
   type=PPRF|http://hl7.org/fhir/v3/ParticipationType - coded participation (primary performer is the attending clinician) 
   actor is Practitioner - reference to Practitioner  (FHIR internal identifier) 
   required=required - coded indicates this participation in the appointment is needed
   status=accepted - coded indicates the practitioner intends to attend
 participant [1]
   type = null
   actor is Patient - reference to Patient (FHIR internal identifier) 
   required=required - coded indicates this participation in the appointment is needed
   status=accepted - coded indicates the patient intends to attend
 participant [2] 
   type = null
   actor is Location - reference to Location (FHIR internal identifier) 
   required=required- coded indicates this participation in the appointment is needed
   status=accepted - coded indicates the location is confirmed

FHIR add/update response (decline)

Appointment
 status=pending - indicates appointment is not confirmed
 start - scheduled visit start date/time
 end - scheduled visit end date/time
 slot - optional reference to a free/busy Slot resource
 comment - optional comment text (will be shown in the PMS)
 participant [0] - participant practitioner
   type=PPRF|http://hl7.org/fhir/v3/ParticipationType - coded participation (primary performer is the attending clinician) 
   actor is Practitioner - reference to Practitioner  (FHIR internal identifier) 
   required=required - coded indicates this participation in the appointment is needed
   status=declined - coded indicates the practitioner system has declined to accept
 participant [1]
   type = null
   actor is Patient - reference to Patient (FHIR internal identifier) 
   required=required - coded indicates this participation in the appointment is needed
   status=needs-action - coded indicates the patient needs to handle this declined request
 participant [2] 
   type = null
   actor is Location - reference to Location (FHIR internal identifier) 
   required=required- coded indicates this participation in the appointment is needed
   status=declined - coded indicates the location system has declined to accept

• The practice adapter forwards to the cloud endpoint these responses from the Oridashi-Hiasobi interface