The Appointment resource are used by several projects to implement communication of information conserning booking and connection to virtual appointments. The resource definition does not support this use-case in a well defined way. There are at least three proposals for supporting virtual Appointments in national profiles either using extensions, virtual Locations/virtual HealthcareServices or some mix:

• [Danish telehealth profile|DK.EHEALTH.SUNDHED.FHIR.IG.CORE\ehealth-videoappointment - FHIR v4.0.1]
• [Au-base profiles|AU Base 2 on FHIR R4]
• Blog post HealthIntersection

The Norwegian are building a common infrastructure for booking of some appointments by the citizens and several systems are in the process of integrating with the services provided. There is also ongoing work in developing a Norwegian base profile as a part of this implementation. The lack of support for virtual appointments in the base standard seems like an oversight and we believe this should be better supported as a part of the 80/20 rule of FHIR.

We want to propose that the Appointment resource includes a separate element designed to express the contact point for a virtual appointment. Maybe as a separate ContactPoint element or as a separate structure (BackboneElement) that can express necessary information relevant for virtual appointments.

We believe a standardized extension could be used for R4 implementation, but that the next release should have native support for this kind of use-case, especially since the use of virtual Encounters and Appointments are much used.