Skip to content

Appointment Profile

Canonicalhttps://fhir.apps.health/StructureDefinition/nexus-emr-core-appointment
Statusdraft · 1.25.1
BaseAppointment (constraint)
SourceFSH · JSON

Minimal Nexus EMR profile for Appointment resources, primarily for mapping status, start date (Last Visit Date), and required patient/practitioner participants. Assumes filtering for status='fulfilled' happens during data retrieval/processing. Contains embedded aliases and invariants.

Overview

Handbook: Scheduling

The narrative treatment -- what this is for, why it is shaped this way, and how it is used.

Nexus EMR Core Appointment Profile

Overview

The Nexus EMR Core Appointment profile represents scheduled patient appointments within primary care EMR systems. This profile captures essential appointment details including scheduling information, participants, status, and service types across the Nexus EMR ecosystem.

Key Features

  • Status Tracking: Monitors appointment lifecycle from proposed through fulfilled or cancelled
  • Participant Management: Tracks patients and healthcare providers involved
  • Service Classification: Categorizes appointments by service type and category
  • Flexible Scheduling: Supports requested versus actual appointment times
  • Raw Code Support: Preserves source EMR appointment type codes

Appointment Status

Common appointment states include:

  • Proposed: Appointment request needs confirmation
  • Pending: Awaiting final confirmation
  • Booked: Confirmed and scheduled
  • Arrived: Patient has checked in
  • Fulfilled: Appointment completed
  • Cancelled: Appointment was cancelled
  • Noshow: Patient did not attend

Clinical Workflows

The appointment profile supports:

  • Scheduling and booking workflows
  • Patient check-in processes
  • Provider schedule management
  • No-show and cancellation tracking
  • Last visit date determination (A12 mapping)

Participant Roles

Appointments track various participants:

  • Patient: The individual receiving care (required)
  • PractitionerRole: providers involved, in their role

Service Types

Common appointment categories include:

  • Primary care visits
  • Specialist consultations
  • Preventive care appointments
  • Follow-up visits
  • Procedure appointments
  • Virtual/telehealth visits

Data Quality Considerations

For systems without explicit "fulfilled" status:

  • Consider appointments as fulfilled if status is (booked OR arrived OR checked-in) AND date is before yesterday
  • This heuristic helps identify completed appointments in systems with limited status tracking

Terminology bindings

Path Strength Value set
Appointment.status required appointmentstatus