Appointment URL links

Note: please see our roadmap page for upcoming changes to the HL7 appointment partner functionality.

URL link to launch a partner appointment booking system

Patients can access appointments via the PKB portal. Appointments received from a secondary care setting (e.g. hospital PAS) are read only to the patient by default. An integration with a partner system is required to allow an appointment to be amended by the patient.

The below is a suggested approach to provide a URL link embedded within an HL7 SIU (appointment) message to PKB. The link would allow the patient from within PKB to launch an appointment booking system so that the patient can change their appointment.

Choosing the source HL7 feed to PKB

Pre-requisite decision. It is recommended that the source of HL7 SIU messages from a customer organisation to PKB should be from one system to support this design paradigm. The source of appointments would typically either be from:

1. The hospital TIE (trust integration engine).

2. An appointment booking system contracted with the trust to provide appointment management functionality to their patients.

PKB does not recommend having more than one source system updating appointments in an organisation's appointment ID namespace because this may result in a race condition between messaging from the different source systems. The sequencing of messaging could be disrupted.

Once it has been decided which source system will send the appointment HL7 SIU feed to PKB, then PKB would suggest the following approach.

Step 1

The appointment booking system and their customer should agree on the format of a URL to embed in HL7 SIU messages to allow the patient to open the appointment booking system from within PKB.

The URL once decided should be included on all HL7 SIU messaging to PKB for the customer organisation from the chosen source system.

An example URL could be:

https://<appointment booking system url>/<pkb_organisation_uuid>/<sender_appointment_uuid>/

Step 2

The appointment booking system will build support into their system for the URL agreed at step 1.

The appointment booking system should consider how to authenticate the user. PKB can only support a static link as provided by the source HL7 message. This static link should provide the necessary authentication into the appointment booking system. The responsibility to authenticate the patient into the appointment booking system is otherwise outside of PKB responsibility.

One option is to display a secondary identity challenge to the user. Here is an example of an identity challenge from DrDoctor. The patient would need to confirm their details associated with the appointment and if successful would be directed to a locked down page to manage the appointment (and only that appointment) identified via the parameters passed on the URL.

The benefit of this approach is that the patient does not need to register a separate account with the appointment booking system. I.e. they are not entering a username or password again.

A further example from Swiftqueue is illustrated in this blog post. This has no identity challenge and authorisation is provided by a URL OTP token: https://blog.patientsknowbest.com/2019/08/22/swiftqueue-integrates-appointment-booking-into-pkb-patient-held-record/

Step 3

The link agreed at step 1 should be embedded into HL7 SIU messaging sent to PKB. The link should be provided within the NTE segment. Here is an example:

MSH|^~\&|Hello7|MyTeam1|HL7API|PKB|20200522120904+0100||SIU^S12|1bdf2671-24be-4cb0-9b72-07164e8589c7|P|2.4|

PID|||9200522998^^^NHS^NH{status:01}~^^^^~^^^^||Patient^20200522^^^Mr||20200522|M|||20200522 Main Street^^London^London^CB11BC^GBR||07720200522^PRS|^NET^^20200522.patient@pkbtest.com|en

SCH|308b5b51-1fbc-4602-b6f0-302991569fa7||||||^Routine^|70b^^Y|||^^^20200522120904+0100^20200522130904+0100

NTE|||Please attend main outpatients department. Please use this link to update your booking: https://example-appointment-manager.co.uk/c4d48ba7-63f9-4887-a423-a578df55d5b7/308b5b51-1fbc-4602-b6f0-302991569fa7/

PV1|||^^^^^^^^Main Outpatients Department

On receipt of the HL7 SIU message, PKB will display the link in the ‘Description’ field of the ‘View Appointment’ page. E.g.

If the patient was to click the above link to launch and manage their appointment then any changes made to the appointment would need to be pushed back to PKB via the chosen source system HL7 feed with the URL included again.

Workflow

The below illustrates the messaging workflow between the customer PAS, customer TIE, appointment booking system and PKB as derived from the above steps.

URL link to launch an online appointment

Online appointments can be sent to patients by embedding a URL link within an HL7 SIU (appointment) message to PKB.

PKB suggests that the link to the appointment is provided in the location field (PV1-3.9) of an SIU message. Here is an example from Imperial:

MSH|^~\&|IMPERIALTIE|IE^|CIE|COMMUNITY|20191205151008+0000|6|SIU^S12|Q489018686T498685796A1116|P|2.3

SCH|18787046.000|||||||Neuro-onc Video Consult New|||^^^20191205151100+0000^20191205161100+0000

PID|||40060422^^^RYJ MRN^MR||ZZZTEST^CIEPPSEVEN^^^MS^^CURRENT||19870917|F|||Flat 1^Elizabeth House^LONDON^^W6 9RB^GBR^HOME^Queen Caroline Street^^||02022222222^PRN|||||||||||||||||N

PV1||O|^^^^^^^^ONLINE AT HTTPS://WWW.IMPERIAL.NHS.UK/VIDEO|||||G9710337^RAJ^INDERJEET|C7077954^Sabir^Ozair|150|||||||||9339045

Various remote consultation tools are used within the NHS. The relevant link for each system would be embedded as above. A further example is Attend Anywhere. For more details on Attend Anywhere please reference our deploy site: https://deploy.patientsknowbest.com/clinical/remote-care-attend-anywhere