eHealth Infrastructure (v2019.6.1)

StructureDefinition: ehealth-videoappointment

Introduction

A video appointment is a booking of a healthcare event among ehealth patients, practitioners, related persons, and locations. Even though a meeting may span a number of participants, only one physical video appointment resource must be created. Participant status (approved, declined etc.) is handled using the AppointmentResponse resource, which in turn updates the status of the participant on the video appointment resource.

Certain data on a video appointment will be provided by the service itself when the video appointment is created, such as the meeting PIN code and the URL at which the meeting takes place. This means that the client must consider the service response instead of just the create request itself, and that the client cannot itself decide the meeting URL or the PIN code, which is defined in the scheduling template.

The most important fields of the ehealth-videoappointment are described below:

  • description: The “subject” of the video appointment (textual description).

  • comment: Free text description of the video appointment to take place.

  • participants: A list of participants invited to the meeting. These may be of type Patient, Practitioner, RelatedPerson, and Location. At least two participants are required. Each participant has a status, which may only be updated by creating an AppointmentResponse. In that case, the status on the Appointment will be updated with the participantStatus sent in the response.

  • start/end: the start and end time of when the appointment is to take place (both required for video appointments).

  • ehealth-responsible (extension): the responsible individual, care team and/or organization for the meeting.

  • appointmentType: the type of appointment booked (checkup, emergency, followup etc).

  • end-meeting-on-end-time (extension): Indicates if the meeting must be terminated at end time.

  • max-participants (extension): The maximum number of participants allowed in the video meeting.

  • meeting-url (extension): the URL used to attend the meeting (provided by the service, not the client).

  • pinCode (extension): The guest pin code to be used when entering the meeting (is provided by the service itself based on the scheduling template used).

If other resources need to be referenced as part of the video appointment, it is possible to reference Condition and Procedure resources as the reason for the meeting, or using “supportingInformation” to reference other resource types.

Scope and Usage

In the eHealth Infrastructure the Appointment resource is used in conjunction with the following resources:

  • Patient
    • If the appointment contains a participant of type Patient
  • Practitioner
    • If the appointment contains a participant of type Practitioner
  • RelatedPerson
    • If the appointment contains a participant of type RelatedPerson
  • Location
    • If the appointment contains a participant of type Location

Formal Views of Profile Content

The official URL for this profile is:

http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-videoappointment

This profile models an ehealth video appointment. It is only necessary to create one appointment even though it spans more than one participant. Allowed appointment participants are patients, practitioners, relatedpersons, and locations

This profile builds on Appointment.

This profile was published on Wed Dec 04 13:16:07 UTC 2019 as a draft by ehealth.sundhed.dk.

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

This structure is derived from Appointment

NameFlagsCard.TypeDescription & Constraintsdoco
.. Appointment I0..*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).
videoresponsible-2: Ensuring that responsible entity is a participating party
... extension 0..*ExtensionSlice: Unordered, Open by value:url
... ehealth-end-meeting-on-end-time 0..1booleanOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-end-meeting-on-end-time
... ehealth-max-participants 0..1integerOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-max-participants
... ehealth-meeting-url 0..1uriOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-meeting-url
... ehealth-vmr-uri 0..1uriOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-vmr-uri
... ehealth-guest-pin-code 0..1stringOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-guest-pin-code
... ehealth-host-pin-code 0..1stringOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-host-pin-code
... ehealth-responsible 0..*Reference(eHealth CareTeam | eHealth Practitioner | eHealth Organization) {r}Optional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible
... identifier 0..*(Slice Definition)Slice: Unordered, Open by value:system
.... identifier:vdxMeetingId 0..1IdentifierIdentifies the FHIR id of the booked VDX meeting resource
..... system 0..1uriFixed Value: http://vdx.medcom.dk/meeting
... appointmentType 1..1CodeableConceptBinding: AppointmentTypeCodes (extensible)
... reason 1..*CodeableConceptBinding: AppointmentReason (preferred)
.... coding 0..*CodingBinding: AppointmentReason (required)
... indication 0..*Reference(Condition | Procedure) {r}
... description 1..1string
... supportingInformation 0..*Reference(Resource) {r}
... start 1..1instant
... end 1..1instant
... slot 0..*Reference(Slot) {r}
... incomingReferral 0..*Reference(ReferralRequest) {r}
... participant 2..*BackboneElement
.... extension 0..*ExtensionSlice: Unordered, Open by value:url
.... ehealth-ext-careteam 0..*Reference()Optional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-ext-careteam
.... actor 0..1Reference(eHealth Patient | eHealth Practitioner | eHealth RelatedPerson | Location)

doco Documentation for this format

This structure is derived from Appointment

NameFlagsCard.TypeDescription & Constraintsdoco
.. Appointment I0..*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).
videoresponsible-2: Ensuring that responsible entity is a participating party
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... ehealth-end-meeting-on-end-time I0..1booleanOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-end-meeting-on-end-time
... ehealth-max-participants I0..1integerOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-max-participants
... ehealth-meeting-url I0..1uriOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-meeting-url
... ehealth-vmr-uri I0..1uriOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-vmr-uri
... ehealth-guest-pin-code I0..1stringOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-guest-pin-code
... ehealth-host-pin-code I0..1stringOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-host-pin-code
... ehealth-responsible I0..*Reference(eHealth CareTeam | eHealth Practitioner | eHealth Organization) {r}Optional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*(Slice Definition)External Ids for this item
Slice: Unordered, Open by value:system
.... identifier:vdxMeetingId Σ0..1IdentifierIdentifies the FHIR id of the booked VDX meeting resource
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required)
..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
..... system Σ0..1uriThe namespace for the identifier value
Fixed Value: http://vdx.medcom.dk/meeting
..... value Σ0..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!Σ1..1codeproposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error
Binding: AppointmentStatus (required)
... serviceCategory Σ0..1CodeableConceptA broad categorisation of the service that is to be performed during this appointment
Binding: ServiceCategory (example)
... serviceType Σ0..*CodeableConceptThe specific service that is to be performed during this appointment
Binding: ServiceType (example)
... specialty Σ0..*CodeableConceptThe specialty of a practitioner that would be required to perform the service requested in this appointment
Binding: Practice Setting Code Value Set (preferred)
... appointmentType Σ1..1CodeableConceptThe style of appointment or patient that has been booked in the slot (not service type)
Binding: AppointmentTypeCodes (extensible)
... reason Σ1..*CodeableConceptReason this appointment is scheduled
Binding: AppointmentReason (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ0..*CodingCode defined by a terminology system
Binding: AppointmentReason (required)
.... text Σ0..1stringPlain text representation of the concept
... indication 0..*Reference(Condition | Procedure) {r}Reason the appointment is to takes place (resource)
... priority 0..1unsignedIntUsed to make informed decisions if needing to re-prioritize
... description 1..1stringShown on a subject line in a meeting request, or appointment list
... supportingInformation 0..*Reference(Resource) {r}Additional information to support the appointment
... start Σ1..1instantWhen appointment is to take place
... end Σ1..1instantWhen appointment is to conclude
... minutesDuration 0..1positiveIntCan be less than start/end (e.g. estimate)
... slot 0..*Reference(Slot) {r}The slots that this appointment is filling
... created 0..1dateTimeThe date that this appointment was initially created
... comment 0..1stringAdditional comments
... incomingReferral 0..*Reference(ReferralRequest) {r}The ReferralRequest provided as information to allocate to the Encounter
... participant I2..*BackboneElementParticipants involved in appointment
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... ehealth-ext-careteam I0..*Reference()Optional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-ext-careteam
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type Σ0..*CodeableConceptRole of participant in the appointment
Binding: ParticipantType (extensible)
.... actor Σ0..1Reference(eHealth Patient | eHealth Practitioner | eHealth RelatedPerson | Location)Person, Location/HealthcareService or Device
.... required Σ0..1coderequired | optional | information-only
Binding: ParticipantRequired (required)
.... status 1..1codeaccepted | declined | tentative | needs-action
Binding: ParticipationStatus (required)
... requestedPeriod 0..*PeriodPotential date/time interval(s) requested to allocate the appointment within

doco Documentation for this format

Differential View

This structure is derived from Appointment

NameFlagsCard.TypeDescription & Constraintsdoco
.. Appointment I0..*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).
videoresponsible-2: Ensuring that responsible entity is a participating party
... extension 0..*ExtensionSlice: Unordered, Open by value:url
... ehealth-end-meeting-on-end-time 0..1booleanOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-end-meeting-on-end-time
... ehealth-max-participants 0..1integerOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-max-participants
... ehealth-meeting-url 0..1uriOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-meeting-url
... ehealth-vmr-uri 0..1uriOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-vmr-uri
... ehealth-guest-pin-code 0..1stringOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-guest-pin-code
... ehealth-host-pin-code 0..1stringOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-host-pin-code
... ehealth-responsible 0..*Reference(eHealth CareTeam | eHealth Practitioner | eHealth Organization) {r}Optional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible
... identifier 0..*(Slice Definition)Slice: Unordered, Open by value:system
.... identifier:vdxMeetingId 0..1IdentifierIdentifies the FHIR id of the booked VDX meeting resource
..... system 0..1uriFixed Value: http://vdx.medcom.dk/meeting
... appointmentType 1..1CodeableConceptBinding: AppointmentTypeCodes (extensible)
... reason 1..*CodeableConceptBinding: AppointmentReason (preferred)
.... coding 0..*CodingBinding: AppointmentReason (required)
... indication 0..*Reference(Condition | Procedure) {r}
... description 1..1string
... supportingInformation 0..*Reference(Resource) {r}
... start 1..1instant
... end 1..1instant
... slot 0..*Reference(Slot) {r}
... incomingReferral 0..*Reference(ReferralRequest) {r}
... participant 2..*BackboneElement
.... extension 0..*ExtensionSlice: Unordered, Open by value:url
.... ehealth-ext-careteam 0..*Reference()Optional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-ext-careteam
.... actor 0..1Reference(eHealth Patient | eHealth Practitioner | eHealth RelatedPerson | Location)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Appointment I0..*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).
videoresponsible-2: Ensuring that responsible entity is a participating party
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... ehealth-end-meeting-on-end-time I0..1booleanOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-end-meeting-on-end-time
... ehealth-max-participants I0..1integerOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-max-participants
... ehealth-meeting-url I0..1uriOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-meeting-url
... ehealth-vmr-uri I0..1uriOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-vmr-uri
... ehealth-guest-pin-code I0..1stringOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-guest-pin-code
... ehealth-host-pin-code I0..1stringOptional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-host-pin-code
... ehealth-responsible I0..*Reference(eHealth CareTeam | eHealth Practitioner | eHealth Organization) {r}Optional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*(Slice Definition)External Ids for this item
Slice: Unordered, Open by value:system
.... identifier:vdxMeetingId Σ0..1IdentifierIdentifies the FHIR id of the booked VDX meeting resource
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ0..1codeusual | official | temp | secondary (If known)
Binding: IdentifierUse (required)
..... type Σ0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
..... system Σ0..1uriThe namespace for the identifier value
Fixed Value: http://vdx.medcom.dk/meeting
..... value Σ0..1stringThe value that is unique
Example General: 123456
..... period Σ0..1PeriodTime period when id is/was valid for use
..... assigner Σ0..1Reference(Organization)Organization that issued id (may be just text)
... status ?!Σ1..1codeproposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error
Binding: AppointmentStatus (required)
... serviceCategory Σ0..1CodeableConceptA broad categorisation of the service that is to be performed during this appointment
Binding: ServiceCategory (example)
... serviceType Σ0..*CodeableConceptThe specific service that is to be performed during this appointment
Binding: ServiceType (example)
... specialty Σ0..*CodeableConceptThe specialty of a practitioner that would be required to perform the service requested in this appointment
Binding: Practice Setting Code Value Set (preferred)
... appointmentType Σ1..1CodeableConceptThe style of appointment or patient that has been booked in the slot (not service type)
Binding: AppointmentTypeCodes (extensible)
... reason Σ1..*CodeableConceptReason this appointment is scheduled
Binding: AppointmentReason (preferred)
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... coding Σ0..*CodingCode defined by a terminology system
Binding: AppointmentReason (required)
.... text Σ0..1stringPlain text representation of the concept
... indication 0..*Reference(Condition | Procedure) {r}Reason the appointment is to takes place (resource)
... priority 0..1unsignedIntUsed to make informed decisions if needing to re-prioritize
... description 1..1stringShown on a subject line in a meeting request, or appointment list
... supportingInformation 0..*Reference(Resource) {r}Additional information to support the appointment
... start Σ1..1instantWhen appointment is to take place
... end Σ1..1instantWhen appointment is to conclude
... minutesDuration 0..1positiveIntCan be less than start/end (e.g. estimate)
... slot 0..*Reference(Slot) {r}The slots that this appointment is filling
... created 0..1dateTimeThe date that this appointment was initially created
... comment 0..1stringAdditional comments
... incomingReferral 0..*Reference(ReferralRequest) {r}The ReferralRequest provided as information to allocate to the Encounter
... participant I2..*BackboneElementParticipants involved in appointment
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
.... ehealth-ext-careteam I0..*Reference()Optional Extensions Element
URL: http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-ext-careteam
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... type Σ0..*CodeableConceptRole of participant in the appointment
Binding: ParticipantType (extensible)
.... actor Σ0..1Reference(eHealth Patient | eHealth Practitioner | eHealth RelatedPerson | Location)Person, Location/HealthcareService or Device
.... required Σ0..1coderequired | optional | information-only
Binding: ParticipantRequired (required)
.... status 1..1codeaccepted | declined | tentative | needs-action
Binding: ParticipationStatus (required)
... requestedPeriod 0..*PeriodPotential date/time interval(s) requested to allocate the appointment within

doco Documentation for this format

 

Terminology Bindings

PathConformanceValueSet
Appointment.languageextensibleCommon Languages
Max Binding: All Languages
Appointment.identifier:vdxMeetingId.userequiredIdentifierUse
Appointment.identifier:vdxMeetingId.typeextensibleIdentifier Type Codes
Appointment.statusrequiredAppointmentStatus
Appointment.serviceCategoryexampleServiceCategory
Appointment.serviceTypeexampleServiceType
Appointment.specialtypreferredPractice Setting Code Value Set
Appointment.appointmentTypeextensibleAppointmentTypeCodes
Appointment.reasonpreferredAppointmentReason
Appointment.reason.codingrequiredAppointmentReason
Appointment.participant.typeextensibleParticipantType
Appointment.participant.requiredrequiredParticipantRequired
Appointment.participant.statusrequiredParticipationStatus

Constraints

IdPathDetailsRequirements
dom-2AppointmentIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1AppointmentIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4AppointmentIf 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-3AppointmentIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
app-3AppointmentOnly proposed or cancelled appointments can be missing start/end dates
: (start.exists() and end.exists()) or (status in ('proposed' | 'cancelled'))
app-2AppointmentEither start and end are specified, or neither
: start.empty() xor end.exists()
videoresponsible-2AppointmentEnsuring that responsible entity is a participating party
: (extension('http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible').value.reference in participant.extension('http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-ext-careteam').value.reference) or (extension('http://ehealth.sundhed.dk/fhir/StructureDefinition/ehealth-responsible').value.reference in participant.actor.reference)
ele-1Appointment.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.participantAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
app-1Appointment.participantEither the type or actor on the participant SHALL be specified
: type.exists() or actor.exists()
ele-1Appointment.participant.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.participant.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Appointment.participant.extensionAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
ext-1Appointment.participant.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
.