HL7 SIU_S14 (Appointment Modification) | Integration Soup HL7 Reference Guide

HL7 SIU_S14 Appointment Modification

The appointment changed, but it was not simply rescheduled, canceled, deleted, or marked as a no-show.

HL7 message structure SIU_S12 groups and segments from HL7 v2.5.1 Hide structure

These are the generated groups and segments for the version selected at the top of the page. The article explains the workflow, and this panel follows the chosen HL7 version.

Message Structure

Segment	Name	Required	Repeatable
MSH	Message Header	Yes	No
SCH	Scheduling Activity Information	Yes	No
TQ1	Timing/Quantity	No	Yes
NTE	Notes and Comments	No	Yes
SIU_S12.PATIENT	Patient group	No	Yes
PID	Patient Identification	Yes	No
PD1	Patient Additional Demographic	No	No
PV1	Patient Visit	No	No
PV2	Patient Visit - Additional Information	No	No
OBX	Observation/Result	No	Yes
DG1	Diagnosis	No	Yes
SIU_S12.RESOURCES	Resources group	Yes	Yes
RGS	Resource Group	Yes	No
SIU_S12.SERVICE	Service group	No	Yes
AIS	Appointment Information	Yes	No
NTE	Notes and Comments	No	Yes
SIU_S12.GENERAL_RESOURCE	General Resource group	No	Yes
AIG	Appointment Information - General Resource	Yes	No
NTE	Notes and Comments	No	Yes
SIU_S12.LOCATION_RESOURCE	Location Resource group	No	Yes
AIL	Appointment Information - Location Resource	Yes	No
NTE	Notes and Comments	No	Yes
SIU_S12.PERSONNEL_RESOURCE	Personnel Resource group	No	Yes
AIP	Appointment Information - Personnel Resource	Yes	No
NTE	Notes and Comments	No	Yes

SIU_S14 notifies receivers that an existing appointment has been modified. In practical interfaces this often means the appointment reason, type, notes, service detail, resource detail, visit context, or patient-facing instructions changed while the appointment remains the same appointment.

S14 uses the shared SIU^S14^SIU_S12 structure. The generated structure panel below is SIU_S12 because the trigger events share the same segment layout.

A small SIU S14 example

MSH|^~\&|SCHED|CITYHOSP|EHR|CITYHOSP|20260716143000||SIU^S14^SIU_S12|SIU140042|P|2.5.1 SCH|A100045|F100045||URGENT^Urgent appointment^L|MODIFIED|OFFICE^Office visit^L|45|min|^^^20260719113000^20260719121500|||||12345^Careful^Clara NTE|1||Patient asked for interpreter support. PID|1||123456^^^CITYHOSP^MR||Smith^Jane^Anne^^Ms^^L||19800314|F|||12 High Street^^Auckland^^1010^NZ^H PV1|1|O|CARD^ROOM2^^CITYHOSP RGS|1 AIS|1||CARDREV^Cardiology review with ECG^L|20260719113000|45|min AIL|1||CARD^ROOM2^^CITYHOSP|20260719113000|45|min AIP|1||12345^Careful^Clara|CARD^Cardiologist^L|20260719113000|45|min

What systems do with it

The sender is the filler schedule. Receivers update the appointment details they store, display, or act on. Reminder systems may change text, portals may change instructions, departmental worklists may change service labels, and resource systems may update preparation or duration.

The appointment identity in SCH is still the anchor. AIS, AIG, AIL, and AIP describe what service, general resource, location, and personnel data now belong to the appointment.

How to read the structure

SIU_S14 uses the common SIU_S12 structure: MSH, SCH, optional timing and notes, optional patient group, and one or more resource groups. The same segment layout can describe many kinds of scheduling changes, so the event code and appointment status/reason fields are what make the business meaning clear.

When the modification changes both time and content, decide whether S13 or S14 is the better event for your interface. Some systems treat any timing change as a reschedule, even if other fields changed at the same time.

Implementation traps

Do not use S14 as a universal "something happened" event. If the appointment was canceled, use S15. If it was entered in error and removed, use S17. If the patient did not arrive, use S26. Receivers often drive very different user workflows from those event codes.

Also be careful with resource replacement. HL7 scheduling guidance separates some service/resource add, modify, cancel, discontinue, and delete cases into their own trigger events. If your receiver cares about individual resources, a single broad S14 may be too vague.

Reference notes

Caristix describes S14 as notifying other applications that an existing appointment has been modified on the filler application. HL7 Chapter 10 scheduling distinguishes modification from rescheduling, cancellation, discontinuation, and deletion. SIU summaries from Rhapsody and iNTERFACEWARE list S14 as one of the shared-format SIU notification events.