{
  "resourceType": "StructureDefinition",
  "id": "nexus-emr-appointment-created-by-extension",
  "url": "https://fhir.apps.health/StructureDefinition/nexus-emr-appointment-created-by-extension",
  "name": "AppointmentCreatedByExtension",
  "title": "Appointment Created By Extension",
  "status": "draft",
  "experimental": true,
  "date": "2026-07-30",
  "publisher": "WELLSTAR Technologies Corp.",
  "contact": [
    {
      "name": "Nexus EMR FHIR Implementation Guide",
      "telecom": [
        {
          "system": "url",
          "value": "https://fhir.apps.health"
        }
      ]
    }
  ],
  "description": "The agent that created the appointment record (createdBy): authoring practitioner/user (Practitioner, or PractitionerRole where the role binding matters), system/integration (Device), self-booking Patient, RelatedPerson, or Organization. Distinct from participants (attendance) and from the native Appointment.created dateTime (when). Reference target mirrors Composition.author.",
  "jurisdiction": [
    {
      "coding": [
        {
          "code": "CA",
          "system": "urn:iso:std:iso:3166",
          "display": "Canada"
        }
      ]
    }
  ],
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    }
  ],
  "kind": "complex-type",
  "abstract": false,
  "context": [
    {
      "type": "element",
      "expression": "Appointment"
    }
  ],
  "type": "Extension",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation": "constraint",
  "snapshot": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "Who/what created the appointment (createdBy)",
        "definition": "The agent responsible for creating the appointment record -- typically the EMR user\n(Practitioner) who booked it, but also a self-booking Patient (online booking), a\nsystem/integration (Device), a RelatedPerson, or an Organization. This is the record's\nauthor, NOT a participant in the visit: the creator is frequently not an attendee (e.g.\nfront-desk staff booking on a provider's behalf). The time of creation is carried\nnatively by Appointment.created.\n\nSemantically equivalent to Provenance.agent with type = author (agent.who), plus\nProvenance.recorded for the timestamp (carried natively by Appointment.created). This\nextension is the lightweight inline form for the common create case; full audit history\n(edits, later agents) remains the domain of Provenance. R4/R5/R6 Appointment define no\nnative author element, so there is no standard element to use instead.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Extension",
          "min": 0,
          "max": "*"
        },
        "condition": [
          "ele-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"
          }
        ],
        "isModifier": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.id",
        "path": "Extension.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "http://hl7.org/fhirpath/System.String",
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ]
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Extension.extension",
        "path": "Extension.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "0",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "representation": [
          "xmlAttr"
        ],
        "short": "identifies the meaning of the extension",
        "definition": "Source of the definition for the extension code - a logical name or a URL.",
        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Extension.url",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "http://hl7.org/fhirpath/System.String",
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "uri"
              }
            ]
          }
        ],
        "fixedUri": "https://fhir.apps.health/StructureDefinition/nexus-emr-appointment-created-by-extension",
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "short": "Authoring agent -- user (Practitioner, or PractitionerRole where the role binding matters), system (Device), self-booking Patient, RelatedPerson, or Organization",
        "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Extension.value[x]",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.apps.health/StructureDefinition/nexus-emr-core-practitioner",
              "https://fhir.apps.health/StructureDefinition/nexus-emr-core-practitionerrole",
              "http://hl7.org/fhir/StructureDefinition/Device",
              "http://hl7.org/fhir/StructureDefinition/Patient",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      }
    ]
  },
  "differential": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "Who/what created the appointment (createdBy)",
        "definition": "The agent responsible for creating the appointment record -- typically the EMR user\n(Practitioner) who booked it, but also a self-booking Patient (online booking), a\nsystem/integration (Device), a RelatedPerson, or an Organization. This is the record's\nauthor, NOT a participant in the visit: the creator is frequently not an attendee (e.g.\nfront-desk staff booking on a provider's behalf). The time of creation is carried\nnatively by Appointment.created.\n\nSemantically equivalent to Provenance.agent with type = author (agent.who), plus\nProvenance.recorded for the timestamp (carried natively by Appointment.created). This\nextension is the lightweight inline form for the common create case; full audit history\n(edits, later agents) remains the domain of Provenance. R4/R5/R6 Appointment define no\nnative author element, so there is no standard element to use instead."
      },
      {
        "id": "Extension.extension",
        "path": "Extension.extension",
        "max": "0"
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "fixedUri": "https://fhir.apps.health/StructureDefinition/nexus-emr-appointment-created-by-extension"
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "short": "Authoring agent -- user (Practitioner, or PractitionerRole where the role binding matters), system (Device), self-booking Patient, RelatedPerson, or Organization",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.apps.health/StructureDefinition/nexus-emr-core-practitioner",
              "https://fhir.apps.health/StructureDefinition/nexus-emr-core-practitionerrole",
              "http://hl7.org/fhir/StructureDefinition/Device",
              "http://hl7.org/fhir/StructureDefinition/Patient",
              "http://hl7.org/fhir/StructureDefinition/RelatedPerson",
              "http://hl7.org/fhir/StructureDefinition/Organization"
            ]
          }
        ],
        "mustSupport": true
      }
    ]
  }
}