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 . Page versions: R5 R4B R4 R3 R2

4.5 Resource Goal - Content

This resource maintained by the Patient Care Work Group

Describes the intended objective(s) of patient care, for example, weight loss, restoring an activity of daily living, etc.

4.5.1 Scope and Usage

A Goal in health care services delivery is 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.

4.5.2 Boundaries and Relationships

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

Goals are often evaluated using Observations.

This resource is referenced by [CarePlan]

4.5.3 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal DomainResourceDescribes the intended objective(s) of patient care
... identifier 0..*IdentifierExternal Ids for this goal
... patient Σ0..1PatientThe patient for whom this goal is intended for
... targetDate Σ0..1dateReach goal on or before
... description Σ1..1stringWhat's the desired outcome?
... status ?! Σ1..1codeproposed | planned | in-progress | achieved | sustaining | cancelled | accepted | rejected
GoalStatus (Required)
... statusDate Σ0..1dateWhen goal status took effect
... author Σ0..1Patient | Practitioner | RelatedPersonWho's responsible for creating Goal?
... priority Σ0..1CodeableConcepthigh | medium |low
GoalPriority (Preferred)
... concern 0..*Condition | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessmentHealth issues this goal addresses
... notes 0..1stringComments about the goal
... outcome 0..*ElementWhat was end result of goal?
.... result[x] Code or observation that resulted from gual
..... resultCodeableConcept0..1CodeableConcept
..... resultReference0..1Observation

UML Diagram

Goal (DomainResource)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)identifier : Identifier 0..*Identifies the patient/subject whose intended care is described by the planpatient : Reference(Patient) 0..1Indicates when the goal is intended to be reachedtargetDate : date 0..1Human-readable description of a specific desired objective of caredescription : string 1..1Indicates whether the goal has been reached and is still considered relevant (this element modifies the meaning of other elements)status : code 1..1 « Indicates whether the goal has been met and is still being targetedGoalStatus »Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etcstatusDate : date 0..1Indicates whose goal this is - patient goal, practitioner goal, etcauthor : Reference(Patient|Practitioner| RelatedPerson) 0..1Identifies the level of importance associated with reaching/sustaining the goalpriority : CodeableConcept 0..1 « The level of importance associated with a goalGoalPriority+ »The identified conditions and other health record elements that are intended to be addressed by the goalconcern : Reference(Condition|Observation| MedicationStatement|NutritionOrder| ProcedureRequest|RiskAssessment) 0..*Any comments related to the goalnotes : string 0..1OutcomeDetails of what's changed (or not changed)result[x] : CodeableConcept|Reference(Observation) 0..1Identifies the change (or lack of change) at the point where the goal was deepmed to be cancelled or achievedoutcome0..*

XML Template

<Goal xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this goal --></identifier>
 <patient><!-- 0..1 Reference(Patient) The patient for whom this goal is intended for --></patient>
 <targetDate value="[date]"/><!-- 0..1 Reach goal on or before -->
 <description value="[string]"/><!-- 1..1 What's the desired outcome? -->
 <status value="[code]"/><!-- 1..1 proposed | planned | in-progress | achieved | sustaining | cancelled | accepted | rejected -->
 <statusDate value="[date]"/><!-- 0..1 When goal status took effect -->
 <author><!-- 0..1 Reference(Patient|Practitioner|RelatedPerson) 
     Who's responsible for creating Goal? --></author>
 <priority><!-- 0..1 CodeableConcept high | medium |low --></priority>
 <concern><!-- 0..* Reference(Condition|Observation|MedicationStatement|
   NutritionOrder|ProcedureRequest|RiskAssessment) Health issues this goal addresses --></concern>
 <notes value="[string]"/><!-- 0..1 Comments about the goal -->
 <outcome>  <!-- 0..* What was end result of goal? -->
  <result[x]><!-- 0..1 CodeableConcept|Reference(Observation) 
      Code or observation that resulted from gual --></result[x]>
 </outcome>
</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
  "patient" : { Reference(Patient) }, // The patient for whom this goal is intended for
  "targetDate" : "<date>", // Reach goal on or before
  "description" : "<string>", // R!  What's the desired outcome?
  "status" : "<code>", // R!  proposed | planned | in-progress | achieved | sustaining | cancelled | accepted | rejected
  "statusDate" : "<date>", // When goal status took effect
  "author" : { Reference(Patient|Practitioner|RelatedPerson) }, // 
     Who's responsible for creating Goal?
  "priority" : { CodeableConcept }, // high | medium |low
  "concern" : [{ Reference(Condition|Observation|MedicationStatement|
   NutritionOrder|ProcedureRequest|RiskAssessment) }], // Health issues this goal addresses
  "notes" : "<string>", // Comments about the goal
  "outcome" : [{ // What was end result of goal?
    // result[x]: Code or observation that resulted from gual. One of these 2:
    "resultCodeableConcept" : { CodeableConcept }
    "resultReference" : { Reference(Observation) }
  }]
}

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal DomainResourceDescribes the intended objective(s) of patient care
... identifier 0..*IdentifierExternal Ids for this goal
... patient Σ0..1PatientThe patient for whom this goal is intended for
... targetDate Σ0..1dateReach goal on or before
... description Σ1..1stringWhat's the desired outcome?
... status ?! Σ1..1codeproposed | planned | in-progress | achieved | sustaining | cancelled | accepted | rejected
GoalStatus (Required)
... statusDate Σ0..1dateWhen goal status took effect
... author Σ0..1Patient | Practitioner | RelatedPersonWho's responsible for creating Goal?
... priority Σ0..1CodeableConcepthigh | medium |low
GoalPriority (Preferred)
... concern 0..*Condition | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessmentHealth issues this goal addresses
... notes 0..1stringComments about the goal
... outcome 0..*ElementWhat was end result of goal?
.... result[x] Code or observation that resulted from gual
..... resultCodeableConcept0..1CodeableConcept
..... resultReference0..1Observation

UML Diagram

Goal (DomainResource)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)identifier : Identifier 0..*Identifies the patient/subject whose intended care is described by the planpatient : Reference(Patient) 0..1Indicates when the goal is intended to be reachedtargetDate : date 0..1Human-readable description of a specific desired objective of caredescription : string 1..1Indicates whether the goal has been reached and is still considered relevant (this element modifies the meaning of other elements)status : code 1..1 « Indicates whether the goal has been met and is still being targetedGoalStatus »Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etcstatusDate : date 0..1Indicates whose goal this is - patient goal, practitioner goal, etcauthor : Reference(Patient|Practitioner| RelatedPerson) 0..1Identifies the level of importance associated with reaching/sustaining the goalpriority : CodeableConcept 0..1 « The level of importance associated with a goalGoalPriority+ »The identified conditions and other health record elements that are intended to be addressed by the goalconcern : Reference(Condition|Observation| MedicationStatement|NutritionOrder| ProcedureRequest|RiskAssessment) 0..*Any comments related to the goalnotes : string 0..1OutcomeDetails of what's changed (or not changed)result[x] : CodeableConcept|Reference(Observation) 0..1Identifies the change (or lack of change) at the point where the goal was deepmed to be cancelled or achievedoutcome0..*

XML Template

<Goal xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this goal --></identifier>
 <patient><!-- 0..1 Reference(Patient) The patient for whom this goal is intended for --></patient>
 <targetDate value="[date]"/><!-- 0..1 Reach goal on or before -->
 <description value="[string]"/><!-- 1..1 What's the desired outcome? -->
 <status value="[code]"/><!-- 1..1 proposed | planned | in-progress | achieved | sustaining | cancelled | accepted | rejected -->
 <statusDate value="[date]"/><!-- 0..1 When goal status took effect -->
 <author><!-- 0..1 Reference(Patient|Practitioner|RelatedPerson) 
     Who's responsible for creating Goal? --></author>
 <priority><!-- 0..1 CodeableConcept high | medium |low --></priority>
 <concern><!-- 0..* Reference(Condition|Observation|MedicationStatement|
   NutritionOrder|ProcedureRequest|RiskAssessment) Health issues this goal addresses --></concern>
 <notes value="[string]"/><!-- 0..1 Comments about the goal -->
 <outcome>  <!-- 0..* What was end result of goal? -->
  <result[x]><!-- 0..1 CodeableConcept|Reference(Observation) 
      Code or observation that resulted from gual --></result[x]>
 </outcome>
</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
  "patient" : { Reference(Patient) }, // The patient for whom this goal is intended for
  "targetDate" : "<date>", // Reach goal on or before
  "description" : "<string>", // R!  What's the desired outcome?
  "status" : "<code>", // R!  proposed | planned | in-progress | achieved | sustaining | cancelled | accepted | rejected
  "statusDate" : "<date>", // When goal status took effect
  "author" : { Reference(Patient|Practitioner|RelatedPerson) }, // 
     Who's responsible for creating Goal?
  "priority" : { CodeableConcept }, // high | medium |low
  "concern" : [{ Reference(Condition|Observation|MedicationStatement|
   NutritionOrder|ProcedureRequest|RiskAssessment) }], // Health issues this goal addresses
  "notes" : "<string>", // Comments about the goal
  "outcome" : [{ // What was end result of goal?
    // result[x]: Code or observation that resulted from gual. One of these 2:
    "resultCodeableConcept" : { CodeableConcept }
    "resultReference" : { Reference(Observation) }
  }]
}

 

Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON)

4.5.3.1 Terminology Bindings

PathDefinitionTypeReference
Goal.status Indicates whether the goal has been met and is still being targetedRequiredhttp://hl7.org/fhir/goal-status
Goal.priority The level of importance associated with a goalPreferredhttp://hl7.org/fhir/vs/goal-priority
Goal.outcome.result[x] 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"UnknownNo details provided yet

4.5.4 Search Parameters

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

NameTypeDescriptionPaths
patientreferenceThe patient for whom this goal is intended forGoal.patient
(Patient)