^S26
SIU^S26 — Notification That Patient Did Not Show Up for Scheduled Appointment
SIU^S26 notifies downstream systems that a patient did not arrive for a scheduled appointment (no-show). It allows clinical and scheduling systems to mark the appointment as a no-show and trigger appropriate follow-up workflows.
When Is This Sent?
When the scheduled appointment time has passed and the patient has not checked in or been seen. Typically triggered by scheduling or front-desk staff marking the appointment as a no-show in the scheduling system.
Real-World Usage
No-show tracking is important for scheduling efficiency, billing, and care management. SIU^S26 enables the RIS to close out the worklist entry without completing the exam, and alerts care coordinators to follow up. It also feeds no-show rate reporting. Many RIS implementations handle this through their own internal workflow rather than via HL7 — confirm with the vendor.
Message Structure
Segment names link to their field-level reference pages.
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|20260316141500||SIU^S26^SIU_S26|SCH00030|P|2.5.1 2SCH||APT20260316001^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
Troubleshooting Scenarios
No-show appointment remains as 'scheduled' status in RIS worklist
Cause
RIS does not process SIU^S26 or does not have a no-show status mapped in its workflow engine.
Fix
Check if the RIS supports S26. If not, consider using an S13 (cancel) as an approximation with a cancellation reason code indicating no-show. Update the interface specification to document this workaround.
No-show notification sent but patient actually arrived late
Cause
Staff marked the patient as no-show prematurely; patient arrived after the S26 was sent.
Fix
Send an SIU^S14 (modification) to update the appointment status back to scheduled/arrived. Establish operational procedures for minimum wait time before no-show is recorded to reduce false no-shows.
Common Confusions
SIU^S26 (No-show) vs SIU^S13 (Cancel). Cancellation is proactive — done before the appointment time. No-show is reactive — the patient simply didn't arrive. They have different operational implications: a cancelled appointment may be rescheduled via normal workflow; a no-show may trigger a care coordinator follow-up or referral back to the ordering physician.
Related Message Types
Segment Reference
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