DSTU2 Ballot Source

This page is part of the FHIR Specification (v0.5.0: DSTU 2 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

StructureDefinition: QICore-Goal

QICore-Goal

Raw XML

<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="goal-qicore-qicore-goal"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <url value="http://hl7.org/fhir/StructureDefinition/goal-qicore-qicore-goal"/>
  <name value="QICore-Goal"/>
  <publisher value="Health Level Seven, Inc. - CQI WG"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org/special/committees/CQI"/>
    </telecom>
  </contact>
  <description value="Profile of Goal for decision support/quality metrics. Defines the core set of elements
   and extensions for quality rule and measure authors."/>
  <status value="draft"/>
  <date value="2015-02-27"/>
  <mapping>
    <identity value="qdm"/>
    <uri value="http://www.healthit.gov/quality-data-model"/>
    <name value="Quality Data Model"/>
  </mapping>
  <type value="constraint"/>
  <abstract value="false"/>
  <base value="http://hl7.org/fhir/StructureDefinition/Goal"/>
  <snapshot>
    <element>
      <path value="Goal"/>
      <name value="QICore-Goal"/>
      <short value="Describes the intended objective(s) of patient care"/>
      <definition value="Describes the intended objective(s) of patient care, for example, weight loss, restoring
       an activity of daily living, etc."/>
      <comments value="Goal can be achieving a particular change or merely maintaining a current state or even
       slowing a decline."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Goal"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="GOL.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode&lt;=OBJ]."/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="Care Goal"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.id"/>
      <short value="Logical id of this artefact"/>
      <definition value="The logical id of the resource, as used in the url for the resoure. Once assigned, this
       value never changes."/>
      <comments value="The only time that a resource does not have an id is when it is being submitted to the
       server using a create operation. Bundles always have an id, though it is usually a generated
       UUID."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
    </element>
    <element>
      <path value="Goal.meta"/>
      <short value="Metadata about the resource"/>
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content may not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Meta"/>
      </type>
    </element>
    <element>
      <path value="Goal.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and
       which must be understood when processing the content."/>
      <comments value="Asserting this rule set restricts the content to be only understood by a limited set of
       trading partners. This inherently limits the usefulness of the data in the long term.
       However the existing health eco-system is highly fractured, and not yet ready to define,
       collect, and exchange data in a generally computable sense. Wherever possible, implementers
       and/or specification writers should avoid using this element as much as possible."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <isModifier value="true"/>
    </element>
    <element>
      <path value="Goal.language"/>
      <short value="Language of the resource content"/>
      <definition value="The base language in which the resource is written."/>
      <comments value="Language is provided to support indexing and accessibility (typically, services such as
       text to speech use the language tag). The html language tag in the narrative applies 
       to the narrative. The language tag on the resource may be used to specify the language
       of other presentations generated from the data in the resource  Not all the content has
       to be in the base language. The Resource.language should not be assumed to apply to the
       narrative automatically. If a language is specified, it should it also be specified on
       the div element in the html (see rules in HTML5 for information about the relationship
       between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <binding>
        <name value="Language"/>
        <strength value="required"/>
        <description value="A human language"/>
        <valueSetUri value="http://tools.ietf.org/html/bcp47"/>
      </binding>
    </element>
    <element>
      <path value="Goal.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition value="A human-readable narrative that contains a summary of the resource, and may be used to
       represent the content of the resource to a human. The narrative need not encode all the
       structured data, but is required to contain sufficient detail to make it &quot;clinically
       safe&quot; for a human to just read the narrative. Resource definitions may define what
       content should be represented in the narrative to ensure clinical safety."/>
      <comments value="Contained resources do not have narrative. Resources that are not contained SHOULD have
       a narrative."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Narrative"/>
      </type>
      <condition value="dom-1"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.contained"/>
      <short value="Contained, inline Resources"/>
      <definition value="These resources do not have an independent existence apart from the resource that contains
       them - they cannot be identified independently, and nor can they have their own independent
       transaction scope."/>
      <comments value="This should never be done when the content can be identified properly, as once identification
       is lost, it is extremely difficult (and context dependent) to restore it again."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Resource"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element>
      <path value="Goal.extension"/>
      <name value="Goal.category"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-category"/>
      </type>
      <binding>
        <name value="QICoreGoalCategory"/>
        <strength value="preferred"/>
        <description value="SHOULD contain a code from SNOMED CT"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/goal-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension"/>
      <name value="Goal.target"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-target"/>
      </type>
      <mapping>
        <identity value="qdm"/>
        <map value="target outcome"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
    </element>
    <element>
      <path value="Goal.extension.extension"/>
      <name value="Goal.target.measure"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-target#measure"/>
      </type>
      <binding>
        <name value="QICoreObservationName"/>
        <strength value="preferred"/>
        <description value="LOINC codes"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/obs-uslab-codes"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Goal.extension.extension"/>
      <name value="Goal.target.detail"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-target#detail"/>
      </type>
      <binding>
        <name value="QICoreObservationCodedResult"/>
        <strength value="preferred"/>
        <description value="SNOMED CT for coded results"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/obs-uslab-codedresults"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Goal.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition value="Source of the definition for the extension code - a logical name or a URL."/>
      <comments value="The definition may point directly to a computable or human-readable definition of the
       extensibility codes, or it may be a logical URI as declared in some other specification.
       The definition should be version specific.  This will ideally be the URI for the Resource
       Profile defining the extension, with the code for the extension after a #."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="uri"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition value="Value of extension - may be a resource or one of a constrained set of the data types (see
       Extensibility in the spec for list)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="*"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension"/>
      <name value="Goal.reasonRejected"/>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-reasonRejected"/>
      </type>
      <binding>
        <name value="QICoreActReason"/>
        <strength value="preferred"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/v3/vs/ActReason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="negation rationale"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource, and that modifies the understanding of the element that contains it.
       Usually modifier elements provide negation or qualification. In order to make the use
       of extensions safe and manageable, there is a strict set of governance applied to the
       definition and use of extensions. Though any implementer is allowed to define an extension,
       there is a set of requirements that SHALL be met as part of the definition of the extension.
       Applications processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.identifier"/>
      <short value="External Ids for this goal"/>
      <definition value="This records identifiers associated with this care plan that are defined by business processed
       and/ or used to refer to it when a direct URL reference to the resource itself is not
       appropriate (e.g. in CDA documents, or in written / printed documentation)."/>
      <requirements value="Need to allow connection to a wider workflow."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Identifier"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.patient"/>
      <short value="The patient for whom this goal is intended for"/>
      <definition value="Identifies the patient/subject whose intended care is described by the plan."/>
      <requirements value="Goals are associated with a patient."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/patient-qicore-qicore-patient"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3-patient ID list"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PAT].role[classCode=PAT]"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.targetDate"/>
      <short value="Reach goal on or before"/>
      <definition value="Indicates when the goal is intended to be reached."/>
      <requirements value="Identifies when the goal should be evaluated."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="date"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Goal.description"/>
      <short value="What's the desired outcome?"/>
      <definition value="Human-readable description of a specific desired objective of care."/>
      <requirements value="Without a description of what's trying to be achieved, element has no purpose."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="GOL-3.2-goal ID.text"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".text"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.status"/>
      <short value="proposed | planned | in-progress | achieved | sustaining | cancelled | accepted | rejected"/>
      <definition value="Indicates whether the goal has been reached and is still considered relevant."/>
      <requirements value="Allows measuring outcome and whether goal needs to be further tracked."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="code"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isSummary value="true"/>
      <binding>
        <name value="GoalStatus"/>
        <strength value="required"/>
        <description value="Indicates whether the goal has been met and is still being targeted"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/goal-status"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="GOL-18-goal life cycle status"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".statusCode in-progress = active (classCode = OBJ) achieved = complete sustaining = active
         (classCode=OBJC) cancelled = aborted"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.statusDate"/>
      <short value="When goal status took effect"/>
      <definition value="Identifies when the current status.  I.e. When initially created, when achieved, when
       cancelled, etc."/>
      <comments value="To see the date for past statuses, query history."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="date"/>
      </type>
      <mustSupport value="true"/>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Goal.author"/>
      <short value="Who's responsible for creating Goal?"/>
      <definition value="Indicates whose goal this is - patient goal, practitioner goal, etc."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Patient"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Practitioner"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element>
      <path value="Goal.priority"/>
      <short value="high | medium |low"/>
      <definition value="Identifies the level of importance associated with reaching/sustaining the goal."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isSummary value="true"/>
      <binding>
        <name value="GoalPriority"/>
        <strength value="preferred"/>
        <description value="The level of importance associated with a goal"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/goal-priority"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value=".priorityCode"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.concern"/>
      <short value="Health issues this goal addresses"/>
      <definition value="The identified conditions and other health record elements that are intended to be addressed
       by the goal."/>
      <requirements value="Allows specific goals to explicitly linked to the concerns they're dealing with - makes
       the goal more understandable."/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/condition-qicore-qicore-condition"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/observation-qicore-qicore-observation"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/medicationstatement-qicore-qicore-medicationstatement"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/procedurerequest-qicore-qicore-procedurerequest"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/RiskAssessment"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".outboundRelationship[typeCode=SUBJ].target[classCode=CONC]"/>
      </mapping>
      <mapping>
        <identity value="qdm"/>
        <map value="related to"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.notes"/>
      <short value="Comments about the goal"/>
      <definition value="Any comments related to the goal."/>
      <comments value="May be used for progress notes, concerns or other related information that doesn't actually
       describe the goal itself."/>
      <requirements value="There's a need to capture information about the goal that doesn't actually describe the
       goal."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="v2"/>
        <map value="GOL-16-goal evaluation + NTE?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;]
        .value"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.outcome"/>
      <short value="What was end result of goal?"/>
      <definition value="Identifies the change (or lack of change) at the point where the goal was deepmed to be
       cancelled or achieved."/>
      <comments value="Note that this should not duplicate the goal status."/>
      <requirements value="Outcome tracking is a key aspect of care planning."/>
      <min value="0"/>
      <max value="*"/>
    </element>
    <element>
      <path value="Goal.outcome.id"/>
      <representation value="xmlAttr"/>
      <short value="xml:id (or equivalent in JSON)"/>
      <definition value="unique id for the element within a resource (for internal references)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="id"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.outcome.extension"/>
      <short value="Additional Content defined by implementations"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. In order to make the use of extensions safe and manageable, there is a
       strict set of governance  applied to the definition and use of extensions. Though any
       implementer is allowed to define an extension, there is a set of requirements that SHALL
       be met as part of the definition of the extension."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.outcome.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element, and that modifies the understanding of the element that contains it. Usually
       modifier elements provide negation or qualification. In order to make the use of extensions
       safe and manageable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension. Applications
       processing a resource are required to check for modifier extensions."/>
      <comments value="There can be no stigma associated with the use of extensions by any application, project,
       or standard - regardless of the institution or jurisdiction that uses or defines the extensions.
        The use of extensions is what allows the FHIR specification to retain a core level of
       simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.outcome.result[x]"/>
      <short value="Code or observation that resulted from gual"/>
      <definition value="Details of what's changed (or not changed)."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
      </type>
      <binding>
        <name value="GoalOutcome"/>
        <strength value="required"/>
        <description value="The result of the goal.  E.g. &quot;25% increase in shoulder mobility&quot;, &quot;Anxiety
         reduced to moderate levels&quot;.  &quot;15 kg weight loss sustained over 6 months&quot;"/>
      </binding>
    </element>
  </snapshot>
  <differential>
    <element>
      <path value="Goal"/>
      <name value="QICore-Goal"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Goal"/>
      </type>
      <mapping>
        <identity value="qdm"/>
        <map value="Care Goal"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
    </element>
    <element>
      <path value="Goal.extension"/>
      <name value="Goal.category"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-category"/>
      </type>
      <binding>
        <name value="QICoreGoalCategory"/>
        <strength value="preferred"/>
        <description value="SHOULD contain a code from SNOMED CT"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/goal-category"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="primary code"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension"/>
      <name value="Goal.target"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-target"/>
      </type>
      <mapping>
        <identity value="qdm"/>
        <map value="target outcome"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.extension.extension"/>
      <slicing>
        <discriminator value="url"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
    </element>
    <element>
      <path value="Goal.extension.extension"/>
      <name value="Goal.target.measure"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-target#measure"/>
      </type>
      <binding>
        <name value="QICoreObservationName"/>
        <strength value="preferred"/>
        <description value="LOINC codes"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/obs-uslab-codes"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Goal.extension.extension"/>
      <name value="Goal.target.detail"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-target#detail"/>
      </type>
      <binding>
        <name value="QICoreObservationCodedResult"/>
        <strength value="preferred"/>
        <description value="SNOMED CT for coded results"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/vs/obs-uslab-codedresults"/>
        </valueSetReference>
      </binding>
    </element>
    <element>
      <path value="Goal.extension"/>
      <name value="Goal.reasonRejected"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/goal-reasonRejected"/>
      </type>
      <binding>
        <name value="QICoreActReason"/>
        <strength value="preferred"/>
        <valueSetReference>
          <reference value="http://hl7.org/fhir/v3/vs/ActReason"/>
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="qdm"/>
        <map value="negation rationale"/>
      </mapping>
    </element>
    <element>
      <path value="Goal.patient"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/patient-qicore-qicore-patient"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Goal.targetDate"/>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Goal.status"/>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Goal.statusDate"/>
      <mustSupport value="true"/>
    </element>
    <element>
      <path value="Goal.concern"/>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/condition-qicore-qicore-condition"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/observation-qicore-qicore-observation"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/medicationstatement-qicore-qicore-medicationstatement"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/procedurerequest-qicore-qicore-procedurerequest"/>
      </type>
      <type>
        <code value="Reference"/>
        <profile value="http://hl7.org/fhir/StructureDefinition/RiskAssessment"/>
      </type>
      <mustSupport value="true"/>
      <mapping>
        <identity value="qdm"/>
        <map value="related to"/>
      </mapping>
    </element>
  </differential>
</StructureDefinition>