Information related to interactions between healthcare providers and a patient.

Data Element
Appointment
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).
Submitted By: Philip Lieberman / Analog Informatics Corporation
Data Element Information
Data Element 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).
Use Case Description(s)
Use Case Description There are currently no FHIR Workflow Resources that are necessary to see patient appointments and the artifacts associated with the longtitudinal history of the patient. This deprives those using the patient record of understanding the history of the patient, actors involved in their care, and different service provider encounter history, as well as their adherance to commitments (no-shows, cancellations).

The FHIR workflow resources provide the ability schedule, reschedule, handle no-shows/cancellations, and provide a view of the history of the patient and their encounters. This information is currently not available in the USCDI data sets.
Estimate the breadth of applicability of the use case(s) for this data element Access to the full breadth of workflow resources (read/write) allow third parties to allow on-line scheduling/rescheduling. It provides the patient with the full list of their appointments and the list of those they have seen or will see. It can radically reduce no-shows by allowing patients to immediately reschedule appointments without making a phone call. We have implemented multilingual scheduling to address the needs of marginalized communities where the providers could not provide staff to serve them.

Access to workflow is one of the largest gaps in the USCDI standard and increases the costs to patients and providers forcing them to use phones where electronic scheduling is technically available, but only provided by high cost private APIs.
ONC Priority
  • Address behavioral health integration with primary care and other physical care
  • Mitigate health and health care inequities and disparities
  • Address the needs of underserved communities
  • Address public health interoperability needs of reporting, investigation, and emergency response
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s) N/A
Additional Specifications https://www.hl7.org/fhir/schedule.html
https://www.hl7.org/fhir/slot.html
https://www.hl7.org/fhir/appointment.html
https://www.hl7.org/fhir/appointmentresponse.html
Current Use (Level 1) Captured, stored, or accessed in at least one production EHR or HIT module
Extent of exchange (Level 2) Between more than two production EHRs or other HIT modules using available interoperability standards
Supporting Artifacts Workflow APIs are supported by most EHRs as part of their limited-access private high-cost tier. See Cerner, Epic and AthenaHealth partner programs.
Potential Challenges
Restrictions on Standardization (e.g. proprietary code) None
Restrictions on Use (e.g. licensing, user fees) None. Currently EHR companies are monitizing patient appointment and workflow access as well as blocking access to perceived competitors.
Privacy and Security Concerns None
Estimate of Overall Burden None
Other Implementation Challenges None
ASTP Evaluation Details
Each submitted Data Element has been evaluated based on the following criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI
Criterion #1
Maturity - Current Standards		 Level 2 - Data element is represented by a terminology standard or SDO-balloted technical specification or implementation guide.
Criterion #2
Maturity - Current Use 		Level 2 - Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
Criterion #3
Maturity - Current Exchange		 Level 2 - Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.
Criterion #4
Use Case(s) - Breadth of Applicability		 Level 2 - Use cases apply to most care settings or specialties.

Comment

Submitted by mturchioe on

ANI's comment on USCDI draft v7: Appointments

ANI strongly supports the addition of Appointment as a new data element within the Encounter Information class. The distinction between a planned appointment and a completed encounter is clinically and operationally significant: it is precisely the information gap that limits nurses, care managers, and transitional care teams from placing individual care events within a longitudinal care plan context. Interoperable appointment data enables care coordinators and nurse navigators to identify upcoming visits across primary care, specialty, and behavioral health settings, supporting proactive gap closure and adherence outreach. This element also carries important health equity implications, as patterns of missed or rescheduled appointments, when captured in a standardized and interoperable form, can signal social determinants of health barriers such as transportation access, work schedule constraints, or childcare needs, enabling nursing-led outreach to address these upstream factors. We recommend that implementation guidance clarify the distinction between Appointment and the existing Encounter Time element to prevent conflation of scheduled versus completed care events in downstream data models and analytics.

Submitted by nicole.toth@pr… on

Concerns Regarding Appointment Resource Expansion in USCDI

With the proposed addition of Appointment resources to USCDI, we are concerned about potential unintended consequences. Specifically, there is apprehension that payers might leverage this information to redirect patients scheduled for procedures at our hospitals to their preferred facilities and providers. While we recognize the value of enhanced transparency, such actions could impact patient choice and continuity of care. At present, it is unclear what steps can be taken to address this possibility, but we believe it warrants further consideration and discussion among stakeholders.

Submitted by csnewman on

Clarify the expectations for the appointment data element

It is unclear what the expectations are for supporting an Appointment data element in the Encounter data class. As described by the Usage Note for Appointment, a future appointment shares many characteristics with a previous encounter (time, location, type, etc). Does USCDI expect these sorts of attributes to be included when exchanging appointment data? Does the Appointment data element simply indicate in some way that the encounter is in the future? Are there unique attributes associated with an Appointment that aren't not associated with a past Encounter? Please clarify the expectations for supporting the concept of an appointment

Log in or register to post comments

FormGuide

Help

1. Optional: Background Text / Cover Letter

The "Optional Background Text / Cover Letter" field provides space for additional context or introductory information related to your comment.

If you wish to provide context, explanation, or an introduction to your comment, enter this information in the field labeled "Optional Background Text / Cover Letter." This is entirely optional and is most useful when submitting multiple related comments or when additional background would help reviewers understand your feedback.

If you are only commenting on a single data class or element, you may leave this field blank.

2. Select the Data Class

To specify which data class your comment addresses:

  1. In the "Data Class" drop-down menu, select the appropriate data class you want to comment on.
  2. If you are providing a general comment that is not specific to a data element, select "General" from the options. Comments with this designation will be displayed on the USCDI landing page.
  3. Note that the Data Class field will automatically populate based on your current location in the platform:
    1. If you are on a data class page, the field will be set to that specific data class
    2. If you are on a data element page, the corresponding data class will be pre-selected
       

3. Select the Data Element

To specify which data element your comment addresses:

  1. In the "Data Element" drop-down menu, select the specific data element you want to comment on.
  2. The drop-down menu will display only the elements available under the data class you selected in the previous step.
  3. You can use the search function within the drop-down to quickly locate a specific data element.
  4. If you are commenting on the data class itself rather than a specific element, you may leave this field blank.

Note: Comments on a specific data element will appear on the respective data element page, while comments on a data class (without a specific element selected) will appear on the landing page for that data class.
 

Data Class and Data Element

Fig 1 The "Data Class" and "Data Element" dropdown menus allow users to specify the exact content they wish to comment on.

4. Optional: Propose New Data Class or Element

If you cannot find the appropriate data class or element for your comment:

  1. Instead of clicking the "Comment On An Existing Data Class Or Element" button, click the adjacent button labeled "Propose a New Data Class or Data Element."
  2. This will redirect you to the ONDEC (ONC New Data Element and Class) Submission System.
  3. In the ONDEC system, follow the provided instructions to submit your proposal for a new data class or element.
  4. Once your proposal is submitted through ONDEC, it will be reviewed separately from the commenting process.
Propose New Data Class or Element

Fig 2 The "Propose a New Data Class or Data Element" button redirects users to the ONDEC Submission System for proposing new data elements not currently available in the system.

5. Complete the Comment Form

Fill out the required fields in the comment form:

Subject: Enter a brief, descriptive title that summarizes your comment. This helps reviewers quickly understand the nature of your feedback.

Comment: In this field, provide the full details of your comment or feedback. Be as clear and specific as possible about your suggestions, concerns, or observations. Include any relevant details that support your position.

6. Optional: Add Additional Comments

If you need to comment on multiple data classes or elements:

  1. After completing your first comment, click the link labeled "Comment on another data element" at the bottom of the form.
  2. A new comment section will appear, allowing you to enter details for your additional comment.
  3. For each additional comment, you must select the appropriate data class and data element from the drop-down menus.
  4. Complete the Subject and Comment fields for your additional comment.
  5. Repeat this process for each additional comment you wish to submit.

Fig 3 The "Comment on another data element" link enables users to create multiple comments addressing different elements within a single submission.

7. Optional: Upload Supporting Files

The platform allows you to upload supporting documentation to enhance your comment:

  • Locate the "File Upload" section at the bottom of the comment form.
  • Click to upload any files (such as PDFs or documents) that provide additional context, evidence, or clarification for your comment.

Important: If you have already entered your comments using the form fields, there is no need to upload duplicate content in PDF format. The file upload feature is intended for supplementary materials only. Please avoid uploading files that contain the same information already provided in your comment text.

Upload Supporting Files

Fig 4 The "File Upload" section permits users to attach supporting documentation that supplements their written comments.

8. Optional: Save and Exit

If you need to pause your work and return to complete your comment later:

  1. Click the "Save and Exit" button at the bottom of the form.
  2. Your comment will be saved as a draft that you can access and complete later.
  3. When you return to the platform, you will see a red triangle with an exclamation mark next to the “Return to saved Comment” button, indicating that you have saved comments in draft status.
  4. Click this button to continue working on your draft.
  5. You will be taken to a review page where you can:
    1. Select "Submit Comment" to officially submit your feedback.
    2. Click "Edit" to return to the comment form and make changes
    3. Select "Discard Draft" to delete the saved draft and start fresh

Fig 5 A red triangle with exclamation mark indicator appears next to the “Return to saved Comment” button when draft comments are saved in the system.

9. Review and Submit

Once you have completed your comment:

  1. Click the "Review and Submit" button at the bottom of the form.
  2. This will take you to a review screen displaying your comment(s) in full.
  3. Review all information for accuracy and completeness.
  4. On this review screen, you have three options: 
    1. Click "Submit Comment" to officially submit your feedback
    2. Click "Edit" to return to the comment form and make changes
    3. Click "Discard Draft" to delete the comment and start fresh
  5. The review screen also includes a "Print" button that allows you to create a printed copy of your comments for your records. 
  6. If you choose to submit, your comment will be recorded in the system and made available for review by the appropriate stakeholders.
Review and Submit

Fig 6 The review screen allows users to verify comment content and make any necessary modifications before final submission.

USCDI Comments

Close

Add a New Comment

Review comment and Submit

Edit
Comment #1