Appointment Integration
- Mohammad Al-Ubaydli
Introduction
Providing patients with their appointments is a standard part of any PKB Trust deployment plan and we encourage our customers to send in all appointments that a patient needs to know about. See here for further considerations when setting up your appointments into PKB.
The Patients Know Best platform includes a "Diary" section, where patients can see the upcoming and past appointments related to their records. Appointments are usually added by way of an HL7 integration, which can facilitate appointments being sent by multiple providers engaged in patient care. PKB also supports patients and carers who manually want to add appointments into their PKB diary.
What is required
The following information supports the customer's understanding of what is required with the HL7 integration.
What data should be supplied
How is that data displayed to patients when they look at appointments within PKB
How an appointment (SIU) HL7 message should be constructed and what data should be added to which segment/field
How can an appointment be updated or cancelled via HL7
How can non-attendance be recorded
Sending a new appointment
New appointments are added to PKB patient records via an HL7 integration using the SIU S12 HL7 message. Whilst the full technical specification is available within our developer wiki, the table below details what appointment information we recommend is provided and where that should be in the HL7 message.
Appointment Data Point | Date point information | Location in HL7 message | UI Display Explanation |
Unique appointment id | A unique identifier must be supplied by the customer for each appointment sent to PKB | SCH-1.1 | Not displayed in the UI |
Appointment Subject | The subject should clearly identify the reason for and nature of the appointment. This includes specifying if it is a virtual (online) or telephone appointment. If not provided all appointments will have a subject of “Appointment” | SCH-7.2 | Displayed in bold for each appointment listed on the Appointments page. Along with the data and time, it is the most prominent information displayed. |
Start Time | When the appointment starts and ends. This should be supplied as a timestamp that includes the date and the time which will be correct at the time of the appointment (e.g. ensuring move from GMT to BST has been accounted for). | SCH-11.4 | Displayed in a large font for each listed appointment. |
End Time | SCH-11.5 | Only displayed when a listed appointment is opened to show more information. | |
Location | Where an appointment requires physical attendance the address is to be provided here (e.g. Room, Building, Street, Town, Post Code)
If physical attendance is not required then a location such as “Telephone” or “Online Meeting” is to be provided. | PV1-3.9 | Displayed in standard font size for each appointment listed on the Appointments page.
Any url link only becomes “clickable” when an appointment is opened to display all details. |
Description | Used to provide more detailed information to the patient about the appointment. This should include details of the Single Point of Contact.
PKB supports the sending of basic html within this field, allowing customers to utilise formatting such as paragraphs, making text bold, new lines etc. | NTE-3.1 | Only displayed when a listed appointment is opened to show more information. |
Speciality / Department | A free text field that can be used to supply the speciality or department the appointment pertains to. | PV1-10.1 | Displayed in standard font size with the label “Speciality”, for each appointment listed on the Appointments page. |
Attendee(s) | Provides details of the personnel that will be attending the appointment (e.g consultant / doctor) At least the family name must be provided. Details of multiple people can be supported by repeating the AIP segment. | AIP-3.2 - (family name) | Displayed in standard font size with the label “Attendees”, for each appointment listed on the Appointments page. |
Below is an example of an SIU S12 HL7 message that includes the data points within the table above.
NB - MSH and PID segments are required (as with all HL7 messages to PKB) but are not included in the example below
SCH|bde4f2b3-360e-4a42-9c3c-769d8fca963d||||||^Followup^|^^|||^^^20220417211709^20220417221709
NTE|||<b>Heading here</b></p>Information about the appointment can be added in here</p></br><b>Point of Contact</b></p>details of who to contact
PV1|||^^^^^^^^Room, Building, Road, Town, Post Code|||||||Oncology
RGS|
AIP|||^Owen^Robyn^^^Miss|^Doctor
The result of this HL7 message within the Appointments page of the PKB UI would be:
When the appointment is clicked to display further information, that would show as follows:
Including a Single Point of Contact
Contact details and relevant information about who patients should contact about an appointment (should they need to do so), is to be provided within the Description field (NTE-3.1) of the HL7 message.
PKB supports the sending of basic html within this field, allowing customers to utilise formatting such as paragraphs, making text bold, new lines etc. Using this capability will help ensure that data is presented in an engaging and accessible way to patients.
Please see the screenshot above for how this would display to a patient viewing an appointment within the PKB user interface
Updating an appointment
Details of existing patient appointments can be amended by sending an SIU S13 or S14 HL7 message, which have exactly the same structure as the S12 HL7 message above.
If an existing appointment is found for the patient with the same unique appointment identifier (value set in SCH-1.1), then that appointment will be updated. If a matching appointment can not be found, then a new one will be created, as long as the minimum required information is present.
If an appointment is updated with a status of Cancelled or Did Not Attend (DNA), it will be changed to active.
Cancelling an appointment
Whilst appointments can not be deleted once sent, they can be cancelled. This is achieved through the sending of an SIU S15 HL7 message.
If an existing appointment is found for the patient with the same unique appointment identifier (value set in SCH-1.1), then that appointment will be set to a status of cancelled. If a matching appointment can not be found, then a new one will be created and set as cancelled, as long as the minimum required information is present.
The patient will see a red notice, in a large font on the appointments listing page which states the appointment is “Cancelled”.
Logging non-attendance by the patient for an appointment
Attendance at an appointment is inferred by it not being set to a status of “Did not attend” (DNA). If an appointment was not attended by the patient then that “status” should be sent to PKB. This is achieved through the sending of aa SIU S26 HL7 message.
If an existing appointment is found for the patient with the same unique appointment identifier (value set in SCH-1.1), then that appointment will be set to a status of DNA. If a matching appointment can not be found, then a new one will be created and the status set as “DNA” , as long as the minimum required information is present.
The patient will see a red notice, in a large font on the appointments listing page which shows the appointment as “Did not attend”.
Further information
Appointment considerations: things to consider when sending appointments into PKB