Eswatini HL7 FHIR Implementation Guide
1.0.0 - draft Eswatini

Eswatini HL7 FHIR Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Eswatini Appointment Profile

Official URL: https://eswatinihie.com/fhir/StructureDefinition/SzAppointment Version: 1.0.0
Active as of 2026-08-21 Computable Name: SzAppointment

The Eswatini Appointment Profile defines the constraints and usage of the HL7 FHIR Appointment resource for use within the Eswatini National Digital Health Ecosystem. It represents a planned healthcare interaction between a patient and a healthcare service, enabling systems to schedule, manage, and track appointments across participating health facilities and services. This profile ensures that appointment information exchanged between systems is standardized and interoperable.

Scope and Usage

This profile SHALL be used by all systems that create, manage, or exchange appointment information, including:

Electronic Medical Record (EMR) systems Appointment and scheduling systems Facility management and referral systems

The profile supports appointments for a wide range of healthcare services, such as:

Clinical consultations Follow-up visits Diagnostic or laboratory services Preventive and public health services Referral and specialist appointments

Appointments may be scheduled in advance, updated, cancelled, or completed as part of routine healthcare delivery.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Appointment C 0..* Appointment 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)
Constraints: app-2, app-3, app-4
... id Σ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... start Σ 1..1 instant When appointment is to take place
... end Σ 1..1 instant When appointment is to conclude
... created 1..1 dateTime The date that this appointment was initially created
... participant C 1..* BackboneElement Participants involved in appointment
Constraints: app-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... actor Σ 1..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location) Person, Location/HealthcareService or Device
.... status Σ 1..1 code accepted | declined | tentative | needs-action
Binding: ParticipationStatus (required): The Participation status of an appointment.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Appointment.status Base required AppointmentStatus 📍4.0.1 FHIR Std.
Appointment.participant.​status Base required ParticipationStatus 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
app-1 error Appointment.participant Either the type or actor on the participant SHALL be specified type.exists() or actor.exists()
app-2 error Appointment Either start and end are specified, or neither start.exists() = end.exists()
app-3 error Appointment Only proposed or cancelled appointments can be missing start/end dates (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4 error Appointment Cancelation reason is only used for appointments that have been cancelled, or no-show Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
dom-2 error Appointment If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Appointment If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Appointment If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Appointment If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Appointment A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Appointment

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Appointment 0..* Appointment 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)
... id 1..1 id Logical id of this artifact
... start 1..1 instant When appointment is to take place
... end 1..1 instant When appointment is to conclude
... participant
.... actor 1..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location) Person, Location/HealthcareService or Device

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Appointment C 0..* Appointment 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)
Constraints: app-2, app-3, app-4
... id Σ 1..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this item
... status ?!Σ 1..1 code proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
Binding: AppointmentStatus (required): The free/busy status of an appointment.
... cancelationReason Σ 0..1 CodeableConcept The coded reason for the appointment being cancelled
Binding: AppointmentCancellationReason (example)
... serviceCategory Σ 0..* CodeableConcept A broad categorization of the service that is to be performed during this appointment
Binding: ServiceCategory (example)
... serviceType Σ 0..* CodeableConcept The specific service that is to be performed during this appointment
Binding: ServiceType (example)
... specialty Σ 0..* CodeableConcept The specialty of a practitioner that would be required to perform the service requested in this appointment
Binding: PracticeSettingCodeValueSet (preferred)
... appointmentType Σ 0..1 CodeableConcept The style of appointment or patient that has been booked in the slot (not service type)
Binding: hl7VS-appointmentReasonCodes (preferred)
... reasonCode Σ 0..* CodeableConcept Coded reason this appointment is scheduled
Binding: EncounterReasonCodes (preferred): The Reason for the appointment to take place.
... reasonReference 0..* Reference(Condition | Procedure | Observation | ImmunizationRecommendation) Reason the appointment is to take place (resource)
... priority 0..1 unsignedInt Used to make informed decisions if needing to re-prioritize
... description 0..1 string Shown on a subject line in a meeting request, or appointment list
... supportingInformation 0..* Reference(Resource) Additional information to support the appointment
... start Σ 1..1 instant When appointment is to take place
... end Σ 1..1 instant When appointment is to conclude
... minutesDuration 0..1 positiveInt Can be less than start/end (e.g. estimate)
... slot 0..* Reference(Slot) The slots that this appointment is filling
... created 1..1 dateTime The date that this appointment was initially created
... comment 0..1 string Additional comments
... patientInstruction 0..1 string Detailed information and instructions for the patient
... basedOn 0..* Reference(ServiceRequest) The service request this appointment is allocated to assess
... participant C 1..* BackboneElement Participants involved in appointment
Constraints: app-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type Σ 0..* CodeableConcept Role of participant in the appointment
Binding: ParticipantType (extensible): Role of participant in encounter.
.... actor Σ 1..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location) Person, Location/HealthcareService or Device
.... required Σ 0..1 code required | optional | information-only
Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
.... status Σ 1..1 code accepted | declined | tentative | needs-action
Binding: ParticipationStatus (required): The Participation status of an appointment.
.... period 0..1 Period Participation period of the actor
... requestedPeriod 0..* Period Potential date/time interval(s) requested to allocate the appointment within

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Appointment.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Appointment.status Base required AppointmentStatus 📍4.0.1 FHIR Std.
Appointment.cancelationReason Base example Appointment cancellation reason 📍4.0.1 FHIR Std.
Appointment.serviceCategory Base example Service category 📍4.0.1 FHIR Std.
Appointment.serviceType Base example Service type 📍4.0.1 FHIR Std.
Appointment.specialty Base preferred Practice Setting Code Value Set 📍4.0.1 FHIR Std.
Appointment.appointmentType Base preferred hl7VS-appointmentReasonCodes 📦3.0.0 THO v7.3
Appointment.reasonCode Base preferred Encounter Reason Codes 📍4.0.1 FHIR Std.
Appointment.participant.​type Base extensible Participant type 📍4.0.1 FHIR Std.
Appointment.participant.​required Base required ParticipantRequired 📍4.0.1 FHIR Std.
Appointment.participant.​status Base required ParticipationStatus 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
app-1 error Appointment.participant Either the type or actor on the participant SHALL be specified type.exists() or actor.exists()
app-2 error Appointment Either start and end are specified, or neither start.exists() = end.exists()
app-3 error Appointment Only proposed or cancelled appointments can be missing start/end dates (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4 error Appointment Cancelation reason is only used for appointments that have been cancelled, or no-show Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
dom-2 error Appointment If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Appointment If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Appointment If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Appointment If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Appointment A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Appointment

Summary

Mandatory: 5 elements

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Appointment C 0..* Appointment 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)
Constraints: app-2, app-3, app-4
... id Σ 1..1 id Logical id of this artifact
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... start Σ 1..1 instant When appointment is to take place
... end Σ 1..1 instant When appointment is to conclude
... created 1..1 dateTime The date that this appointment was initially created
... participant C 1..* BackboneElement Participants involved in appointment
Constraints: app-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... actor Σ 1..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location) Person, Location/HealthcareService or Device
.... status Σ 1..1 code accepted | declined | tentative | needs-action
Binding: ParticipationStatus (required): The Participation status of an appointment.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Appointment.status Base required AppointmentStatus 📍4.0.1 FHIR Std.
Appointment.participant.​status Base required ParticipationStatus 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
app-1 error Appointment.participant Either the type or actor on the participant SHALL be specified type.exists() or actor.exists()
app-2 error Appointment Either start and end are specified, or neither start.exists() = end.exists()
app-3 error Appointment Only proposed or cancelled appointments can be missing start/end dates (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4 error Appointment Cancelation reason is only used for appointments that have been cancelled, or no-show Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
dom-2 error Appointment If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Appointment If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Appointment If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Appointment If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Appointment A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from Appointment

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Appointment 0..* Appointment 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)
... id 1..1 id Logical id of this artifact
... start 1..1 instant When appointment is to take place
... end 1..1 instant When appointment is to conclude
... participant
.... actor 1..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location) Person, Location/HealthcareService or Device

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Appointment C 0..* Appointment 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)
Constraints: app-2, app-3, app-4
... id Σ 1..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this item
... status ?!Σ 1..1 code proposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
Binding: AppointmentStatus (required): The free/busy status of an appointment.
... cancelationReason Σ 0..1 CodeableConcept The coded reason for the appointment being cancelled
Binding: AppointmentCancellationReason (example)
... serviceCategory Σ 0..* CodeableConcept A broad categorization of the service that is to be performed during this appointment
Binding: ServiceCategory (example)
... serviceType Σ 0..* CodeableConcept The specific service that is to be performed during this appointment
Binding: ServiceType (example)
... specialty Σ 0..* CodeableConcept The specialty of a practitioner that would be required to perform the service requested in this appointment
Binding: PracticeSettingCodeValueSet (preferred)
... appointmentType Σ 0..1 CodeableConcept The style of appointment or patient that has been booked in the slot (not service type)
Binding: hl7VS-appointmentReasonCodes (preferred)
... reasonCode Σ 0..* CodeableConcept Coded reason this appointment is scheduled
Binding: EncounterReasonCodes (preferred): The Reason for the appointment to take place.
... reasonReference 0..* Reference(Condition | Procedure | Observation | ImmunizationRecommendation) Reason the appointment is to take place (resource)
... priority 0..1 unsignedInt Used to make informed decisions if needing to re-prioritize
... description 0..1 string Shown on a subject line in a meeting request, or appointment list
... supportingInformation 0..* Reference(Resource) Additional information to support the appointment
... start Σ 1..1 instant When appointment is to take place
... end Σ 1..1 instant When appointment is to conclude
... minutesDuration 0..1 positiveInt Can be less than start/end (e.g. estimate)
... slot 0..* Reference(Slot) The slots that this appointment is filling
... created 1..1 dateTime The date that this appointment was initially created
... comment 0..1 string Additional comments
... patientInstruction 0..1 string Detailed information and instructions for the patient
... basedOn 0..* Reference(ServiceRequest) The service request this appointment is allocated to assess
... participant C 1..* BackboneElement Participants involved in appointment
Constraints: app-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type Σ 0..* CodeableConcept Role of participant in the appointment
Binding: ParticipantType (extensible): Role of participant in encounter.
.... actor Σ 1..1 Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Device | HealthcareService | Location) Person, Location/HealthcareService or Device
.... required Σ 0..1 code required | optional | information-only
Binding: ParticipantRequired (required): Is the Participant required to attend the appointment.
.... status Σ 1..1 code accepted | declined | tentative | needs-action
Binding: ParticipationStatus (required): The Participation status of an appointment.
.... period 0..1 Period Participation period of the actor
... requestedPeriod 0..* Period Potential date/time interval(s) requested to allocate the appointment within

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Appointment.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Appointment.status Base required AppointmentStatus 📍4.0.1 FHIR Std.
Appointment.cancelationReason Base example Appointment cancellation reason 📍4.0.1 FHIR Std.
Appointment.serviceCategory Base example Service category 📍4.0.1 FHIR Std.
Appointment.serviceType Base example Service type 📍4.0.1 FHIR Std.
Appointment.specialty Base preferred Practice Setting Code Value Set 📍4.0.1 FHIR Std.
Appointment.appointmentType Base preferred hl7VS-appointmentReasonCodes 📦3.0.0 THO v7.3
Appointment.reasonCode Base preferred Encounter Reason Codes 📍4.0.1 FHIR Std.
Appointment.participant.​type Base extensible Participant type 📍4.0.1 FHIR Std.
Appointment.participant.​required Base required ParticipantRequired 📍4.0.1 FHIR Std.
Appointment.participant.​status Base required ParticipationStatus 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
app-1 error Appointment.participant Either the type or actor on the participant SHALL be specified type.exists() or actor.exists()
app-2 error Appointment Either start and end are specified, or neither start.exists() = end.exists()
app-3 error Appointment Only proposed or cancelled appointments can be missing start/end dates (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist'))
app-4 error Appointment Cancelation reason is only used for appointments that have been cancelled, or no-show Appointment.cancelationReason.exists() implies (Appointment.status='no-show' or Appointment.status='cancelled')
dom-2 error Appointment If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Appointment If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Appointment If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Appointment If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Appointment A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Appointment

Summary

Mandatory: 5 elements

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Core Data Requirements

The Eswatini Appointment Profile constrains the base FHIR Appointment resource to ensure capture of essential national scheduling information, including:

Appointment status to reflect the lifecycle of the appointment (e.g., proposed, booked, cancelled, fulfilled) Service category and/or type describing the nature of the planned service Start and end date/time defining when the appointment is scheduled to occur Participants, including the patient and healthcare service providers involved Location or service delivery organization

These elements enable consistent management of appointment workflows and support patient follow-up and service continuity.

Interoperability and National Alignment

This profile is designed to:

Conform to HL7 FHIR R4 Appointment semantics Support interoperability within the Eswatini National HIE Enable linkage with related resources such as Patient, Practitioner, Organization, Location, and Encounter Facilitate coordinated care, referral management, and reduction of missed appointments

Where terminology bindings are applied, the use of nationally approved code systems is encouraged to ensure consistent interpretation across systems.

Data Quality and Conformance

Systems claiming conformance to this profile SHALL:

Populate all required and Must Support elements as defined by the profile Maintain accurate appointment status updates throughout the scheduling lifecycle Ensure participant roles and scheduling details reflect real operational workflows

Optional elements from the base Appointment resource may be used when relevant, provided they do not conflict with the constraints defined in this profile.

Extensibility

The Eswatini Appointment Profile supports future expansion through standard FHIR extensibility mechanisms. Additional program-specific scheduling requirements, reminders, or workflow enhancements may be introduced using FHIR extensions, subject to national governance and approval.

Summary

The Eswatini Appointment Profile provides a standardized and interoperable representation of healthcare appointments, supporting efficient scheduling, improved care coordination, and continuity of services across the national health system. Adoption of this profile enables better patient management, reduced missed visits, and improved service delivery throughout the Kingdom of Eswatini.