^S14
SIU^S14 — Notification of Appointment Modification
SIU^S14 notifies downstream systems that an existing appointment has been modified — for example, rescheduled to a different date/time, changed to a different procedure, or updated with new patient or provider information.
When Is This Sent?
When a scheduler modifies a booked appointment in the scheduling system: changing the date, time, procedure, location, or provider.
Real-World Usage
Appointment reschedules are common — patients call to move appointments, clinicians change procedures after new orders. SIU^S14 must be received and processed by the RIS to update the modality worklist. If modifications aren't flowing, technologists prepare for the wrong procedure or exam at the wrong time. The SCH.1 appointment ID must be consistent between the original S12 and the S14.
Message Structure
Segment names link to their field-level reference pages.
| # | Segment | Purpose in this message | Req | Repeat |
|---|---|---|---|---|
| 1 | MSH | Message header with SIU^S14 in MSH.9 | R | — |
| 2 | SCH | Updated scheduling details with same appointment ID as original S12 | R | — |
| 3 | PID | Patient demographics | R | — |
| 4 | PV1 | Patient visit context | R | — |
| 5 | AIS | Updated appointment service information | R | — |
| 6 | NTE | Notes about the modification | O | Yes |
| 7 | AIG | Updated resource allocation | O | Yes |
| 8 | AIP | Updated personnel allocation | O | Yes |
Example Message
Realistic example with fake patient data. Paste into the HL7 Message Viewer to explore interactively.
1MSH||^~\&|EPIC_SCHED|HOSPITAL_A|MIRTH_PROD|RIS|20260313100000||SIU^S14^SIU_S14|SCH00015|P|2.5.1 2SCH||APT20260312001^EPIC_SCHED||||||71046^Chest 2 Views^CPT4||60^MIN|||||5678^Wilson^Dr.^Sarah 3PID||1||234567^^^HOSP_A^MR||Johnson^Sarah^L||19920601|F 4PV1||1|O|RADOUT^1^^HOSP_A||||5678^Wilson^Dr.^Sarah 5AIS||1||71046^Chest 2 Views^CPT4|||60^MIN
Troubleshooting Scenarios
RIS creates a duplicate appointment instead of updating the existing one
Cause
The RIS cannot match SCH.1 (appointment ID) from the S14 to the original appointment. Either the appointment ID wasn't stored on S12, or it's formatted differently in the S14.
Fix
Confirm the SCH.1 value is identical in both the S12 and S14. Check the RIS's appointment matching logic — it should use SCH.1 as the primary key for modifications. If the RIS uses accession number instead of appointment ID, map accordingly in the interface engine.
Modality worklist still shows old procedure after reschedule
Cause
RIS received the S14 and updated its internal record but did not push a worklist update to the modality (C-FIND response update).
Fix
Verify the RIS is configured to send a worklist update (DICOM MWL push or C-FIND invalidation) when an appointment is modified. Some RIS systems require explicit configuration to propagate scheduling changes to the MWL.
Common Confusions
SIU^S14 (Modify) vs SIU^S12 (New) vs ORM^O01 (Order). SIU^S14 modifies an existing appointment — the appointment ID must already exist in the receiving system. Sending S14 for an appointment that doesn't exist will cause an error or a duplicate. Always send S12 first, then S14 for subsequent changes. ORM^O01 changes the clinical order; SIU^S14 changes the scheduling record.
Related Message Types
Segment Reference
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