Only confirmed, cancelled, checkin_at, start_time, end_time, operatory_id and note can be patched. The next sync from the health record system overwrites any other field. checkin_at cannot be in the future and cannot be cleared. start_time and end_time go together.

Time, operatory_id and note changes are written to Denticon, Dentrix, Dentrix Enterprise, Eaglesoft and Open Dental. Other systems return 400 EMR does not support appointment update for a time or note change; a change to operatory_id alone is accepted and stays in NexHealth. checkin_at is written to Denticon, Dentrix, Dentrix Enterprise, Eaglesoft, ModMed, NextGen Office and Open Dental. cancelled is written to every system except OrthoTrac and PracticeWorks. confirmed: true is written to every system; confirmed: false only to the five systems that take appointment updates. On the other systems the change stays in NexHealth.

On a live practice the appointment must have reached the system (foreign_id set) before you can patch anything but cancelled. A cancelled appointment and a scheduling block cannot be patched.

When the write finishes in the system, appointment_updated fires on success, or appointment_updated.failed, appointment_updated.timed_out or appointment_updated.incomplete otherwise, with previous_attributes showing the field you changed. See Testing writes, per system.