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9.6 Resource Goal - Content

Patient Care Work Group Maturity Level : 2   Trial Use Security Category : Patient Compartments : Patient

Describes the intended objective(s) for a patient, group or organization care, for example, weight loss, restoring an activity of daily living, obtaining herd immunity via immunization, meeting a process improvement objective, etc.

A Goal in health care services delivery is generally an expressed desired health state to be achieved by a subject of care (or family/group) over a period or at a specific point of time. This desired target health state may be achieved as a result of health care intervention(s) or resulting from natural recovery over time. For example:

  • A goal of a plan for a condition such as a diabetes might specify desired outcome(s) (e.g. HgbA1c level =<5.6% in 3 months) as a result of interventions such as medication therapy, nutritional management and/or increase physical activity.
  • A goal of a procedure might be to meet the intended objective of the procedure (e.g. wet-dry-dressing changes twice a day; goal: wound healed completely in 2 weeks) or to prevent an unintended complication (e.g. repositioning a patient every two hours: goal to maintain skin integrity)

Goals may address the prevention of illness, cure or mitigation of a condition, prolongation of life, or mitigation of pain and discomfort.

When dealing with groups, goals may also reflect health state, such as a reduction of addiction behaviors. However, they may also reflect population health objectives such as education, screening, etc.

Organizational goals are typically not health state specific but may instead identify measurement targets such as infection control, cost management, patient satisfaction, etc.

Goals are typically established in the context of a CarePlan . However, goals may also be directly referenced by request-type resources (e.g. MedicationRequest or ReferralRequest ServiceRequest ) by using an extension.

A goal represents a specific goal instance for a particular patient, group, etc. It is not intended to be used to define types of potential goals as part of an order set or protocol definition. Protocol definitions and order sets are supported through PlanDefinition . The Goal resource is intended to be used once an order set is instantiated or assigned to a patient, which is when the potential goals become the actual goals, if not changed or deleted.

Goals are often evaluated using Observations .

Goal does not include the legal Advance Directives, which should be represented with the Consent resource with Consent.category = Advance Directive or a request resource with the intent = directive. Legal Advance Directives may specify clinical goals that can be represented as a Goal resource as well. Informally, advance directives could be represented as a Goal resource regardless of whether it was included in the legal Consent, such as "I want to die at home."

This resource is referenced by careplan CarePlan .

This resource does not implement any patterns.

Structure

Name Flags Card. Type Description & Constraints doco
. . Goal TU DomainResource Describes the intended objective(s) for a patient, group or organization
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier External Ids for this goal
. . . status lifecycleStatus ?! Σ 1..1 code proposed | planned | accepted | planned active | in-progress on-hold | on-target completed | ahead-of-target cancelled | behind-target entered-in-error | sustaining rejected
GoalLifecycleStatus ( Required )
... achievementStatus Σ 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | on-hold sustaining | cancelled not-achieved | entered-in-error no-progress | rejected not-attainable
GoalStatus Goal achievement status ( Required Preferred )
. . . category Σ 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc.
GoalCategory Goal category ( Example )
. . . continuous 0..1 boolean After meeting the goal, ongoing activity is needed to sustain the goal objective
.. . priority Σ 0..1 CodeableConcept high-priority | medium-priority | low-priority
GoalPriority Goal priority ( Preferred )
. . . description Σ 1..1 CodeableConcept Code or text describing goal
SNOMED CT Clinical Findings ( Example )
. . . subject Σ 0..1 1..1 Reference ( Patient | Group | Organization ) Who this goal is intended for
. . . start[x] Σ 0..1 When goal pursuit begins
GoalStartEvent Goal start event ( Example )
. . . . startDate date
. . . . startCodeableConcept CodeableConcept
. . . target I 0..1 0..* BackboneElement Target outcome for the goal
+ Rule: Goal.target.measure is required if Goal.target.detail is populated
. . . . measure Σ I 0..1 CodeableConcept The parameter whose value is being tracked
LOINC Codes ( Example )
. . . . detail[x] Σ I 0..1 The target value to be achieved
. . . . . detailQuantity Quantity
. . . . . detailRange Range
. . . . . detailCodeableConcept CodeableConcept
. . . . . detailString string
..... detailBoolean boolean
..... detailInteger integer
..... detailRatio Ratio
. . . . due[x] Σ 0..1 Reach goal on or before
. . . . . dueDate date
. . . . . dueDuration Duration
. . . statusDate Σ 0..1 date When goal status took effect
. . . statusReason 0..1 string Reason for current status
. . . expressedBy Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson ) Who's responsible for creating Goal?
. . . addresses 0..* Reference ( Condition | Observation | MedicationStatement MedicationUsage | MedicationRequest | NutritionOrder | ProcedureRequest ServiceRequest | RiskAssessment ) Issues addressed by this goal
. . . note 0..* Annotation Comments about the goal
. . . outcomeCode 0..* CodeableConcept What result was achieved regarding the goal?
SNOMED CT Clinical Findings ( Example )
. . . outcomeReference 0..* Reference ( Observation ) Observation that resulted from goal

doco Documentation for this format

UML Diagram ( Legend )

Goal ( DomainResource ) This records Business identifiers associated with assigned to this care plan that are defined goal by business processes and/or used to refer to it when a direct URL reference to the performer or other systems which remain constant as the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation) updated and propagates from server to server identifier : Identifier [0..*] Indicates whether The state of the goal has been reached and is still considered relevant throughout its lifecycle (this element modifies the meaning of other elements) status lifecycleStatus : code [1..1] « Indicates whether Codes that reflect the current state of a goal has been met and whether the goal is still being targeted targeted. (Strength=Required) GoalStatus GoalLifecycleStatus ! » Describes the progression, or lack thereof, towards the goal against the target achievementStatus : CodeableConcept [0..1] « Indicates the progression, or lack thereof, towards the goal against the target. (Strength=Preferred) GoalAchievementStatus ? » Indicates a category the goal falls within category : CodeableConcept [0..*] « Codes for grouping and sorting goals goals. (Strength=Example) GoalCategory ?? » After meeting the goal, ongoing activity is needed to sustain the goal objective continuous : boolean [0..1] Identifies the mutually agreed level of importance associated with reaching/sustaining the goal priority : CodeableConcept [0..1] « The level of importance associated with a goal goal. (Strength=Preferred) GoalPriority ? » Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding" description : CodeableConcept [1..1] « Codes providing the details of a particular goal. This will generally be system or implementation guide-specific. In many systems, only the text element will be used. (Strength=Example) SNOMED CT Clinical Findings SNOMEDCTClinicalFindings ?? » Identifies the patient, group or organization for whom the goal is being established subject : Reference [0..1] [1..1] « Patient | Group | Organization » The date or event after which the goal should begin being pursued start[x] : Type [0..1] « date | CodeableConcept ; Codes describing events that can trigger the initiation of a goal goal. (Strength=Example) GoalStartEvent ?? » Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc statusDate : date [0..1] Captures the reason for the current status statusReason : string [0..1] Indicates whose goal this is - patient goal, practitioner goal, etc expressedBy : Reference [0..1] « Patient | Practitioner | PractitionerRole | RelatedPerson » The identified conditions and other health record elements that are intended to be addressed by the goal addresses : Reference [0..*] « Condition | Observation | MedicationUsage | MedicationStatement MedicationRequest | NutritionOrder | ProcedureRequest ServiceRequest | RiskAssessment » Any comments related to the goal note : Annotation [0..*] Identifies the change (or lack of change) at the point when the status of the goal is assessed outcomeCode : CodeableConcept [0..*] « The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months" months". (Strength=Example) SNOMED CT Clinical Findings SNOMEDCTClinicalFindings ?? » Details of what's changed (or not changed) outcomeReference : Reference [0..*] « Observation » Target The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level measure : CodeableConcept [0..1] « Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. (Strength=Example) LOINC LOINCCodes ?? » The target value of the focus to be achieved to signify the fulfillment of the goal, e.g. 150 pounds, 7.0%. Either the high or low or both values of the range can be specified. When a low value is missing, it indicates that the goal is achieved at any focus value at or below the high value. Similarly, if the high value is missing, it indicates that the goal is achieved at any focus value at or above the low value detail[x] : Type [0..1] « Quantity | Range | CodeableConcept | string | boolean | integer | Ratio » Indicates either the date or the duration after start by which the goal should be met due[x] : Type [0..1] « date | Duration » Indicates what should be done by when target [0..1] [0..*]

XML Template

<Goal xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>
 <

 <identifier><!-- 0..* Identifier External Ids for this goal --></identifier>
 <lifecycleStatus value="[code]"/><!-- 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected -->
 <achievementStatus><!-- 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable --></achievementStatus>

 <category><!-- 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc. --></category>
 <continuous value="[boolean]"/><!-- 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective -->

 <priority><!-- 0..1 CodeableConcept high-priority | medium-priority | low-priority --></priority>
 <description><!-- 1..1 CodeableConcept Code or text describing goal --></description>
 <</subject>

 <subject><!-- 1..1 Reference(Group|Organization|Patient) Who this goal is intended for --></subject>

 <start[x]><!-- 0..1 date|CodeableConcept When goal pursuit begins --></start[x]>
 <

 <target>  <!-- ?? 0..* Target outcome for the goal -->

  <measure><!-- ?? 0..1 CodeableConcept The parameter whose value is being tracked --></measure>
  <</detail[x]>

  <detail[x]><!-- ?? 0..1 Quantity|Range|CodeableConcept|string|boolean|integer|
    Ratio The target value to be achieved --></detail[x]>
  <due[x]><!-- 0..1 date|Duration Reach goal on or before --></due[x]>
 </target>
 <statusDate value="[date]"/><!-- 0..1 When goal status took effect -->
 <statusReason value="[string]"/><!-- 0..1 Reason for current status -->
 <</expressedBy>
 <|
   </addresses>

 <expressedBy><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who's responsible for creating Goal? --></expressedBy>
 <addresses><!-- 0..* Reference(Condition|MedicationRequest|MedicationUsage|
   NutritionOrder|Observation|RiskAssessment|ServiceRequest) Issues addressed by this goal --></addresses>
 <note><!-- 0..* Annotation Comments about the goal --></note>
 <outcomeCode><!-- 0..* CodeableConcept What result was achieved regarding the goal? --></outcomeCode>
 <outcomeReference><!-- 0..* Reference(Observation) Observation that resulted from goal --></outcomeReference>
</Goal>

JSON Template

{doco
  "resourceType" : "Goal",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "

  "identifier" : [{ Identifier }], // External Ids for this goal
  "lifecycleStatus" : "<code>", // R!  proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  "achievementStatus" : { CodeableConcept }, // in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable

  "category" : [{ CodeableConcept }], // E.g. Treatment, dietary, behavioral, etc.
  "continuous" : <boolean>, // After meeting the goal, ongoing activity is needed to sustain the goal objective

  "priority" : { CodeableConcept }, // high-priority | medium-priority | low-priority
  "description" : { CodeableConcept }, // R!  Code or text describing goal
  "

  "subject" : { Reference(Group|Organization|Patient) }, // R!  Who this goal is intended for

  // start[x]: When goal pursuit begins. One of these 2:
  "startDate" : "<date>",
  "startCodeableConcept" : { CodeableConcept },
  "

  "target" : [{ // C? Target outcome for the goal

    "measure" : { CodeableConcept }, // C? The parameter whose value is being tracked
    

    // detail[x]: The target value to be achieved. One of these 7:
    "detailQuantity" : { Quantity },
    "detailRange" : { Range },
    "detailCodeableConcept" : { CodeableConcept },
    "detailString" : "<string>",
    "detailBoolean" : <boolean>,
    "detailInteger" : <integer>,
    "detailRatio" : { Ratio },

    // due[x]: Reach goal on or before. One of these 2:
    "dueDate" : "<date>"
    "dueDuration" : { Duration }
  },

  }],

  "statusDate" : "<date>", // When goal status took effect
  "statusReason" : "<string>", // Reason for current status
  "
  "|
   

  "expressedBy" : { Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who's responsible for creating Goal?
  "addresses" : [{ Reference(Condition|MedicationRequest|MedicationUsage|
   NutritionOrder|Observation|RiskAssessment|ServiceRequest) }], // Issues addressed by this goal
  "note" : [{ Annotation }], // Comments about the goal
  "outcomeCode" : [{ CodeableConcept }], // What result was achieved regarding the goal?
  "outcomeReference" : [{ Reference(Observation) }] // Observation that resulted from goal
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:Goal;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:
  fhir:

  fhir:Goal.identifier [ Identifier ], ... ; # 0..* External Ids for this goal
  fhir:Goal.lifecycleStatus [ code ]; # 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  fhir:Goal.achievementStatus [ CodeableConcept ]; # 0..1 in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable

  fhir:Goal.category [ CodeableConcept ], ... ; # 0..* E.g. Treatment, dietary, behavioral, etc.
  fhir:Goal.continuous [ boolean ]; # 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective

  fhir:Goal.priority [ CodeableConcept ]; # 0..1 high-priority | medium-priority | low-priority
  fhir:Goal.description [ CodeableConcept ]; # 1..1 Code or text describing goal
  fhir:

  fhir:Goal.subject [ Reference(Group|Organization|Patient) ]; # 1..1 Who this goal is intended for

  # Goal.start[x] : 0..1 When goal pursuit begins. One of these 2
    fhir:Goal.startDate [ date ]
    fhir:Goal.startCodeableConcept [ CodeableConcept ]
  fhir:

  fhir:Goal.target [ # 0..* Target outcome for the goal

    fhir:Goal.target.measure [ CodeableConcept ]; # 0..1 The parameter whose value is being tracked
    # . One of these 3

    # Goal.target.detail[x] : 0..1 The target value to be achieved. One of these 7

      fhir:Goal.target.detailQuantity [ Quantity ]
      fhir:Goal.target.detailRange [ Range ]
      fhir:Goal.target.detailCodeableConcept [ CodeableConcept ]
      fhir:Goal.target.detailString [ string ]
      fhir:Goal.target.detailBoolean [ boolean ]
      fhir:Goal.target.detailInteger [ integer ]
      fhir:Goal.target.detailRatio [ Ratio ]

    # Goal.target.due[x] : 0..1 Reach goal on or before. One of these 2
      fhir:Goal.target.dueDate [ date ]
      fhir:Goal.target.dueDuration [ Duration ]
  ];

  ], ...;

  fhir:Goal.statusDate [ date ]; # 0..1 When goal status took effect
  fhir:Goal.statusReason [ string ]; # 0..1 Reason for current status
  fhir:
  fhir:|
  

  fhir:Goal.expressedBy [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who's responsible for creating Goal?
  fhir:Goal.addresses [ Reference(Condition|MedicationRequest|MedicationUsage|NutritionOrder|Observation|
  RiskAssessment|ServiceRequest) ], ... ; # 0..* Issues addressed by this goal
  fhir:Goal.note [ Annotation ], ... ; # 0..* Comments about the goal
  fhir:Goal.outcomeCode [ CodeableConcept ], ... ; # 0..* What result was achieved regarding the goal?
  fhir:Goal.outcomeReference [ Reference(Observation) ], ... ; # 0..* Observation that resulted from goal
]

Changes since DSTU2 R3

Goal Goal.description Type changed from string to CodeableConcept
Goal.target Goal.lifecycleStatus
  • Renamed Change value set from target[x] http://hl7.org/fhir/ValueSet/goal-status|4.0.0 to target Remove date, Remove Quantity{http://hl7.org/fhir/StructureDefinition/Duration} Goal.target.measure Added Element Goal.target.detail[x] Added Element http://hl7.org/fhir/ValueSet/goal-status|4.1.0
Goal.target.due[x] Goal.continuous
  • Added Element
Goal.statusReason Goal.addresses
  • Type changed from CodeableConcept to string Goal.expressedBy Renamed from author to expressedBy Goal.outcomeCode Added Element Goal.outcomeReference Reference: Added Element Target Types MedicationUsage, MedicationRequest
  • Goal.outcome
  • deleted Type Reference: Removed Target Type MedicationStatement

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and 2 all r3 resources are invalid (2 errors). ). valid.)

Structure

Name Flags Card. Type Description & Constraints doco
. . Goal TU DomainResource Describes the intended objective(s) for a patient, group or organization
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier External Ids for this goal
. . . status lifecycleStatus ?! Σ 1..1 code proposed | planned | accepted | planned active | in-progress on-hold | on-target completed | ahead-of-target cancelled | behind-target entered-in-error | sustaining rejected
GoalLifecycleStatus ( Required )
... achievementStatus Σ 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | on-hold sustaining | cancelled not-achieved | entered-in-error no-progress | rejected not-attainable
GoalStatus Goal achievement status ( Required Preferred )
. . . category Σ 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc.
GoalCategory Goal category ( Example )
. . . continuous 0..1 boolean After meeting the goal, ongoing activity is needed to sustain the goal objective
.. . priority Σ 0..1 CodeableConcept high-priority | medium-priority | low-priority
GoalPriority Goal priority ( Preferred )
. . . description Σ 1..1 CodeableConcept Code or text describing goal
SNOMED CT Clinical Findings ( Example )
. . . subject Σ 0..1 1..1 Reference ( Patient | Group | Organization ) Who this goal is intended for
. . . start[x] Σ 0..1 When goal pursuit begins
GoalStartEvent Goal start event ( Example )
. . . . startDate date
. . . . startCodeableConcept CodeableConcept
. . . target I 0..1 0..* BackboneElement Target outcome for the goal
+ Rule: Goal.target.measure is required if Goal.target.detail is populated
. . . . measure Σ I 0..1 CodeableConcept The parameter whose value is being tracked
LOINC Codes ( Example )
. . . . detail[x] Σ I 0..1 The target value to be achieved
. . . . . detailQuantity Quantity
. . . . . detailRange Range
. . . . . detailCodeableConcept CodeableConcept
. . . . . detailString string
..... detailBoolean boolean
..... detailInteger integer
..... detailRatio Ratio
. . . . due[x] Σ 0..1 Reach goal on or before
. . . . . dueDate date
. . . . . dueDuration Duration
. . . statusDate Σ 0..1 date When goal status took effect
. . . statusReason 0..1 string Reason for current status
. . . expressedBy Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson ) Who's responsible for creating Goal?
. . . addresses 0..* Reference ( Condition | Observation | MedicationStatement MedicationUsage | MedicationRequest | NutritionOrder | ProcedureRequest ServiceRequest | RiskAssessment ) Issues addressed by this goal
. . . note 0..* Annotation Comments about the goal
. . . outcomeCode 0..* CodeableConcept What result was achieved regarding the goal?
SNOMED CT Clinical Findings ( Example )
. . . outcomeReference 0..* Reference ( Observation ) Observation that resulted from goal

doco Documentation for this format

UML Diagram ( Legend )

Goal ( DomainResource ) This records Business identifiers associated with assigned to this care plan that are defined goal by business processes and/or used to refer to it when a direct URL reference to the performer or other systems which remain constant as the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation) updated and propagates from server to server identifier : Identifier [0..*] Indicates whether The state of the goal has been reached and is still considered relevant throughout its lifecycle (this element modifies the meaning of other elements) status lifecycleStatus : code [1..1] « Indicates whether Codes that reflect the current state of a goal has been met and whether the goal is still being targeted targeted. (Strength=Required) GoalStatus GoalLifecycleStatus ! » Describes the progression, or lack thereof, towards the goal against the target achievementStatus : CodeableConcept [0..1] « Indicates the progression, or lack thereof, towards the goal against the target. (Strength=Preferred) GoalAchievementStatus ? » Indicates a category the goal falls within category : CodeableConcept [0..*] « Codes for grouping and sorting goals goals. (Strength=Example) GoalCategory ?? » After meeting the goal, ongoing activity is needed to sustain the goal objective continuous : boolean [0..1] Identifies the mutually agreed level of importance associated with reaching/sustaining the goal priority : CodeableConcept [0..1] « The level of importance associated with a goal goal. (Strength=Preferred) GoalPriority ? » Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding" description : CodeableConcept [1..1] « Codes providing the details of a particular goal. This will generally be system or implementation guide-specific. In many systems, only the text element will be used. (Strength=Example) SNOMED CT Clinical Findings SNOMEDCTClinicalFindings ?? » Identifies the patient, group or organization for whom the goal is being established subject : Reference [0..1] [1..1] « Patient | Group | Organization » The date or event after which the goal should begin being pursued start[x] : Type [0..1] « date | CodeableConcept ; Codes describing events that can trigger the initiation of a goal goal. (Strength=Example) GoalStartEvent ?? » Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc statusDate : date [0..1] Captures the reason for the current status statusReason : string [0..1] Indicates whose goal this is - patient goal, practitioner goal, etc expressedBy : Reference [0..1] « Patient | Practitioner | PractitionerRole | RelatedPerson » The identified conditions and other health record elements that are intended to be addressed by the goal addresses : Reference [0..*] « Condition | Observation | MedicationUsage | MedicationStatement MedicationRequest | NutritionOrder | ProcedureRequest ServiceRequest | RiskAssessment » Any comments related to the goal note : Annotation [0..*] Identifies the change (or lack of change) at the point when the status of the goal is assessed outcomeCode : CodeableConcept [0..*] « The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months" months". (Strength=Example) SNOMED CT Clinical Findings SNOMEDCTClinicalFindings ?? » Details of what's changed (or not changed) outcomeReference : Reference [0..*] « Observation » Target The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level measure : CodeableConcept [0..1] « Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. (Strength=Example) LOINC LOINCCodes ?? » The target value of the focus to be achieved to signify the fulfillment of the goal, e.g. 150 pounds, 7.0%. Either the high or low or both values of the range can be specified. When a low value is missing, it indicates that the goal is achieved at any focus value at or below the high value. Similarly, if the high value is missing, it indicates that the goal is achieved at any focus value at or above the low value detail[x] : Type [0..1] « Quantity | Range | CodeableConcept | string | boolean | integer | Ratio » Indicates either the date or the duration after start by which the goal should be met due[x] : Type [0..1] « date | Duration » Indicates what should be done by when target [0..1] [0..*]

XML Template

<Goal xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>
 <

 <identifier><!-- 0..* Identifier External Ids for this goal --></identifier>
 <lifecycleStatus value="[code]"/><!-- 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected -->
 <achievementStatus><!-- 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable --></achievementStatus>

 <category><!-- 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc. --></category>
 <continuous value="[boolean]"/><!-- 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective -->

 <priority><!-- 0..1 CodeableConcept high-priority | medium-priority | low-priority --></priority>
 <description><!-- 1..1 CodeableConcept Code or text describing goal --></description>
 <</subject>

 <subject><!-- 1..1 Reference(Group|Organization|Patient) Who this goal is intended for --></subject>

 <start[x]><!-- 0..1 date|CodeableConcept When goal pursuit begins --></start[x]>
 <

 <target>  <!-- ?? 0..* Target outcome for the goal -->

  <measure><!-- ?? 0..1 CodeableConcept The parameter whose value is being tracked --></measure>
  <</detail[x]>

  <detail[x]><!-- ?? 0..1 Quantity|Range|CodeableConcept|string|boolean|integer|
    Ratio The target value to be achieved --></detail[x]>
  <due[x]><!-- 0..1 date|Duration Reach goal on or before --></due[x]>
 </target>
 <statusDate value="[date]"/><!-- 0..1 When goal status took effect -->
 <statusReason value="[string]"/><!-- 0..1 Reason for current status -->
 <</expressedBy>
 <|
   </addresses>

 <expressedBy><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who's responsible for creating Goal? --></expressedBy>
 <addresses><!-- 0..* Reference(Condition|MedicationRequest|MedicationUsage|
   NutritionOrder|Observation|RiskAssessment|ServiceRequest) Issues addressed by this goal --></addresses>
 <note><!-- 0..* Annotation Comments about the goal --></note>
 <outcomeCode><!-- 0..* CodeableConcept What result was achieved regarding the goal? --></outcomeCode>
 <outcomeReference><!-- 0..* Reference(Observation) Observation that resulted from goal --></outcomeReference>
</Goal>

JSON Template

{doco
  "resourceType" : "Goal",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "

  "identifier" : [{ Identifier }], // External Ids for this goal
  "lifecycleStatus" : "<code>", // R!  proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  "achievementStatus" : { CodeableConcept }, // in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable

  "category" : [{ CodeableConcept }], // E.g. Treatment, dietary, behavioral, etc.
  "continuous" : <boolean>, // After meeting the goal, ongoing activity is needed to sustain the goal objective

  "priority" : { CodeableConcept }, // high-priority | medium-priority | low-priority
  "description" : { CodeableConcept }, // R!  Code or text describing goal
  "

  "subject" : { Reference(Group|Organization|Patient) }, // R!  Who this goal is intended for

  // start[x]: When goal pursuit begins. One of these 2:
  "startDate" : "<date>",
  "startCodeableConcept" : { CodeableConcept },
  "

  "target" : [{ // C? Target outcome for the goal

    "measure" : { CodeableConcept }, // C? The parameter whose value is being tracked
    

    // detail[x]: The target value to be achieved. One of these 7:
    "detailQuantity" : { Quantity },
    "detailRange" : { Range },
    "detailCodeableConcept" : { CodeableConcept },
    "detailString" : "<string>",
    "detailBoolean" : <boolean>,
    "detailInteger" : <integer>,
    "detailRatio" : { Ratio },

    // due[x]: Reach goal on or before. One of these 2:
    "dueDate" : "<date>"
    "dueDuration" : { Duration }
  },

  }],

  "statusDate" : "<date>", // When goal status took effect
  "statusReason" : "<string>", // Reason for current status
  "
  "|
   

  "expressedBy" : { Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who's responsible for creating Goal?
  "addresses" : [{ Reference(Condition|MedicationRequest|MedicationUsage|
   NutritionOrder|Observation|RiskAssessment|ServiceRequest) }], // Issues addressed by this goal
  "note" : [{ Annotation }], // Comments about the goal
  "outcomeCode" : [{ CodeableConcept }], // What result was achieved regarding the goal?
  "outcomeReference" : [{ Reference(Observation) }] // Observation that resulted from goal
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:Goal;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root
  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:
  fhir:

  fhir:Goal.identifier [ Identifier ], ... ; # 0..* External Ids for this goal
  fhir:Goal.lifecycleStatus [ code ]; # 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  fhir:Goal.achievementStatus [ CodeableConcept ]; # 0..1 in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable

  fhir:Goal.category [ CodeableConcept ], ... ; # 0..* E.g. Treatment, dietary, behavioral, etc.
  fhir:Goal.continuous [ boolean ]; # 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective

  fhir:Goal.priority [ CodeableConcept ]; # 0..1 high-priority | medium-priority | low-priority
  fhir:Goal.description [ CodeableConcept ]; # 1..1 Code or text describing goal
  fhir:

  fhir:Goal.subject [ Reference(Group|Organization|Patient) ]; # 1..1 Who this goal is intended for

  # Goal.start[x] : 0..1 When goal pursuit begins. One of these 2
    fhir:Goal.startDate [ date ]
    fhir:Goal.startCodeableConcept [ CodeableConcept ]
  fhir:

  fhir:Goal.target [ # 0..* Target outcome for the goal

    fhir:Goal.target.measure [ CodeableConcept ]; # 0..1 The parameter whose value is being tracked
    # . One of these 3

    # Goal.target.detail[x] : 0..1 The target value to be achieved. One of these 7

      fhir:Goal.target.detailQuantity [ Quantity ]
      fhir:Goal.target.detailRange [ Range ]
      fhir:Goal.target.detailCodeableConcept [ CodeableConcept ]
      fhir:Goal.target.detailString [ string ]
      fhir:Goal.target.detailBoolean [ boolean ]
      fhir:Goal.target.detailInteger [ integer ]
      fhir:Goal.target.detailRatio [ Ratio ]

    # Goal.target.due[x] : 0..1 Reach goal on or before. One of these 2
      fhir:Goal.target.dueDate [ date ]
      fhir:Goal.target.dueDuration [ Duration ]
  ];

  ], ...;

  fhir:Goal.statusDate [ date ]; # 0..1 When goal status took effect
  fhir:Goal.statusReason [ string ]; # 0..1 Reason for current status
  fhir:
  fhir:|
  

  fhir:Goal.expressedBy [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who's responsible for creating Goal?
  fhir:Goal.addresses [ Reference(Condition|MedicationRequest|MedicationUsage|NutritionOrder|Observation|
  RiskAssessment|ServiceRequest) ], ... ; # 0..* Issues addressed by this goal
  fhir:Goal.note [ Annotation ], ... ; # 0..* Comments about the goal
  fhir:Goal.outcomeCode [ CodeableConcept ], ... ; # 0..* What result was achieved regarding the goal?
  fhir:Goal.outcomeReference [ Reference(Observation) ], ... ; # 0..* Observation that resulted from goal
]

Changes since DSTU2 Release 3

Goal Goal.description Type changed from string to CodeableConcept
Goal.target Goal.lifecycleStatus
  • Renamed Change value set from target[x] http://hl7.org/fhir/ValueSet/goal-status|4.0.0 to target Remove date, Remove Quantity{http://hl7.org/fhir/StructureDefinition/Duration} Goal.target.measure Added Element Goal.target.detail[x] Added Element http://hl7.org/fhir/ValueSet/goal-status|4.1.0
Goal.target.due[x] Goal.continuous
  • Added Element
Goal.statusReason Goal.addresses
  • Type changed from CodeableConcept to string Goal.expressedBy Renamed from author to expressedBy Goal.outcomeCode Added Element Goal.outcomeReference Reference: Added Element Target Types MedicationUsage, MedicationRequest
  • Goal.outcome
  • deleted Type Reference: Removed Target Type MedicationStatement

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and 2 all r3 resources are invalid (2 errors). ). valid.)

 

Alternate See the Profiles & Extensions and the alternate definitions: Master Definition ( XML , + JSON ), , XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a

Goal.status
Path Definition Type Reference
Goal.lifecycleStatus Indicates whether Codes that reflect the current state of a goal has been met and whether the goal is still being targeted targeted. Required GoalStatus GoalLifecycleStatus
Goal.achievementStatus Indicates the progression, or lack thereof, towards the goal against the target. Preferred GoalAchievementStatus
Goal.category Codes for grouping and sorting goals goals. Example GoalCategory
Goal.priority The level of importance associated with a goal goal. Preferred GoalPriority
Goal.description Codes providing the details of a particular goal. This will generally be system or implementation guide-specific. In many systems, only the text element will be used. Example SNOMED CT Clinical Findings SNOMEDCTClinicalFindings
Goal.start[x] Codes describing events that can trigger the initiation of a goal goal. Example GoalStartEvent
Goal.target.measure Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. Example LOINC Codes LOINCCodes
Goal.target.detail[x] Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal. Unknown No details provided yet
Goal.outcomeCode The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months" months". Example SNOMED CT Clinical Findings SNOMEDCTClinicalFindings

id Level Location Description Expression
gol-1 : On Goal.target: Rule Goal.target Goal.target.measure is required if Goal.target.detail is populated ( expression on Goal.target: (detail.exists() and measure.exists()) or detail.exists().not() )

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
achievement-status token in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Goal.achievementStatus
category token E.g. Treatment, dietary, behavioral, etc. Goal.category
identifier token External Ids for this goal Goal.identifier 26 30 Resources
lifecycle-status token proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Goal.lifecycleStatus
patient reference Who this goal is intended for Goal.subject Goal.subject.where(resolve() is Patient)
( Patient )
31 33 Resources
start-date date When goal pursuit begins Goal.start.as(Date) status token proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected Goal.status (Goal.start as date)
subject reference Who this goal is intended for Goal.subject
( Group , Organization , Patient )
target-date date Reach goal on or before Goal.target.due.as(Date) (Goal.target.due as date)