Health New Zealand Te Whatu Ora Shared Care FHIR API - Local Development build (v0.4.5) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Dunedin Hospital Outpatients

The Outpatients Appointments API exposes Hospital Outpatient appointments as FHIR Appointments and other related resources. The API provides a single view of outpatient appointments from multiple appointment scheduling systems used within Health NZ.

This allows an appointment management solution to display appointment information and as functionality to manage the workflow of appointments, including confirming, arriving and departing a patient from their appointment.

Currently, the APIs support integration with the following Hospital Outpatients systems:

• SIPICS – Te Waipounamu regional Patient Administration System (PAS), including clinic-based appointments as well as other ad hoc and day surgery appointments.
• Cardiobase – Southern district Cardiology information system for Cardiology procedure appointments.
• Karisma – Southern district Radiology information system for Radiology procedure appointments.

Some functionality of the API is currently limited based on the underlying appointment booking system:

• Southern Radiology appointments only support retrieval. Updates (confirm, arrive, depart) are not currently supported.

Additionally, a Patient resource is exposed to provide Patient demographic information held within the Hospital Patient Administration System (PAS). This provides the ability to update a limited set of patient demographics held in the PAS (contact details).

Appointment Modality

In this IG, the appointment method (how the appointment will be delivered) is conveyed using the Appointment.extension:appointmentMethod extension and is the authoritative indicator of delivery method: in-person, telephone, telehealth, or home-visit.

Location references are used to express “where”, and are expected to remain meaningful regardless of method (i.e., they are not a proxy for appointment method).

For in-person, the Appointment should include a facility/clinic Location representing where the patient is expected to attend.

For telephone and telehealth, implementers should still include an appropriate Location when available, such as the service owning clinic/site and/or a virtual Location (rather than omitting Location entirely), so operational workflows (routing, clinic ownership, reporting) remain intact.

For home-visit, the Appointment should include a Location representing the patient’s home/visit location when it is represented as a Location resource.

In all cases, do not infer appointment method from Location; use extension:appointmentMethod for method and Location purely for location context.

Use Cases

1. Appointment Created or Updated
2. Confirm Appointment
3. Arrive Appointment
4. Depart Appointment
5. Retrieve or Update Te Waipounamu Patient Demographics

Appointment Created Or Updated

An event notification will be sent to subscribers for any new or updated appointments, the details can then be retrieved from the Appointment API.

Confirm Appointment

Update the Appointment Scheduling System to indicate the Patient has confirmed they can attend the appointment.

Key information:

Element	Expected update/information
AppointmentResponse.appointment	Appointment.Identifier
AppointmentResponse.participantType	http://terminology.hl7.org/CodeSystem/v3-ParticipationType#SBJ
AppointmentResponse.participantStatus	'accepted'

see AppointmentResponse example

Arrive Appointment

Update the Appointment Scheduling System to indicate the patient has arrived for their appointment.

Key information:

Element	Expected update/information
Encounter.status	'arrived'
Encounter.class	https://terminology.hl7.org/3.1.0/ValueSet-v3-ActEncounterCode.html AMB
Encounter.subject	Patient.Identifier
Encounter.appointment	Appointment.Identifier

see Encounter create example

Depart Appointment

Update the Appointment Scheduling System to indicate the patient has departed from their appointment.

Key information:

Element	Expected update/information
Encounter.appointment.identifier	Appointment.Identifier
Encounter.subject	Patient.Identifier
Encounter.status	'finished'
Encounter.period.start	arrival time
Encounter.period.end	departure time

see Encounter update example

Retrieve Or Update Te Waipounamu Patient Demographics

Retrieve Patient Demographics from a Patient in the Te Waipounamu regional Patient Administration System.

Update contact details (phone/email) for the patient.

Note: Email address will not be automatically available after an update as a verification process with the patient must occur first. Once validated, the email will appear in the Patient resource.

Key information (for update):

Element	Expected update/information
Patient.identifier	patient's NHI
Patient.status	'finished'
Patient.telecom.system	'phone'
Patient.telecom.use	'home'
Patient.telecom.value	patient's phone number
Patient.telecom.system	'email'
Patient.telecom.use	'home'
Patient.telecom.value	patient's email address

see Patient Response example