Connectathon 11 Snapshot

This page is part of the FHIR Specification (v1.2.0: STU 3 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

F.16.1.4 StructureDefinition: QICore-Goal - Detailed Descriptions

Definitions for the qicore-goal Profile.

Goal(QICore-Goal)
Definition

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.

Control0..*
TypeGoal
Comments

Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

Goal.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
Comments

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.

Goal.meta
Definition

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.

Control0..1
TypeMeta
Goal.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Control0..1
Typeuri
Is Modifiertrue
Comments

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.

Goal.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
Typecode
Comments

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).

Goal.text
Definition

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 "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

Goal.contained
Definition

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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

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.

Goal.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension (http://hl7.org/fhir/StructureDefinition/goal-target)
Definition

The element describing the target for the goal, allowing the progress of the goal to be monitored against an observation.

Control0..*
TypeExtension (Extension Type: Choice of: boolean, integer, decimal, base64Binary, instant, string, uri, date, dateTime, time, code, oid, id, unsignedInt, positiveInt, markdown, Annotation, Attachment, Identifier, CodeableConcept, Coding, Quantity, Range, Period, Ratio, SampledData, Signature, HumanName, Address, ContactPoint, Timing, Reference, Meta)
Goal.extension.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension(measure)
Definition

The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

Control1..1
TypeExtension
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension(detail)
Definition

The target value range 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.

Control1..1
TypeExtension
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension
Definition

An Extension

Control0..*
TypeExtension
SlicingThis element introduces a set of slices. The slicing rules are:
  • unordered
  • Open
  • discriminators: url
Goal.extension.extension (http://hl7.org/fhir/StructureDefinition/goal-target#measure)
Definition

The element describing the target for the goal, allowing the progress of the goal to be monitored against an observation.

Control0..*
TypeExtension (Extension Type: Choice of: boolean, integer, decimal, base64Binary, instant, string, uri, date, dateTime, time, code, oid, id, unsignedInt, positiveInt, markdown, Annotation, Attachment, Identifier, CodeableConcept, Coding, Quantity, Range, Period, Ratio, SampledData, Signature, HumanName, Address, ContactPoint, Timing, Reference, Meta)
Goal.extension.extension (http://hl7.org/fhir/StructureDefinition/goal-target#detail)
Definition

The element describing the target for the goal, allowing the progress of the goal to be monitored against an observation.

Control0..*
TypeExtension (Extension Type: Choice of: boolean, integer, decimal, base64Binary, instant, string, uri, date, dateTime, time, code, oid, id, unsignedInt, positiveInt, markdown, Annotation, Attachment, Identifier, CodeableConcept, Coding, Quantity, Range, Period, Ratio, SampledData, Signature, HumanName, Address, ContactPoint, Timing, Reference, Meta)
Goal.extension.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

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 #.

Fixed Valuehttp://hl7.org/fhir/StructureDefinition/goal-target
Goal.extension.value[x]
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control0..0
TypeChoice of: boolean, integer, decimal, base64Binary, instant, string, uri, date, dateTime, time, code, oid, id, unsignedInt, positiveInt, markdown, Annotation, Attachment, Identifier, CodeableConcept, Coding, Quantity, Range, Period, Ratio, SampledData, Signature, HumanName, Address, ContactPoint, Timing, Reference, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Goal.extension (http://hl7.org/fhir/StructureDefinition/goal-reasonRejected)
Definition

The reason the goal was not accepted. Applies only if the status of the goal is rejected.

Control0..1
TypeExtension (Extension Type: CodeableConcept)
Goal.modifierExtension
Definition

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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
Comments

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.

Goal.identifier
Definition

This records identifiers associated with this care plan that are defined by business processes 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).

Control0..*
TypeIdentifier
Requirements

Need to allow connection to a wider workflow.

Goal.subject
Definition

Identifies the patient, group or organization for whom the goal is being established.

Control0..1
TypeChoice of: Reference(QICore-Patient), Reference(Group), Reference(QICore-Organization)
Must Supporttrue
Requirements

Subject is optional to support annonymized reporting.

Goal.start[x]
Definition

The date or event after which the goal should begin being pursued.

Control0..1
BindingCodes describing events that can trigger the initiation of a goal
For example codes, see GoalStartEvent
TypeChoice of: date, CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

Goals can be established prior to there being an intention to start pursuing them; e.g. Goals for post-surgical recovery established prior to surgery.

Goal.target[x]
Definition

Indicates either the date or the duration after start by which the goal should be met.

Control0..1
TypeChoice of: date, Quantity(Duration)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

Identifies when the goal should be evaluated.

Goal.category
Definition

Indicates a category the goal falls within.

Control0..*
BindingCodes for grouping and sorting goals
For example codes, see GoalCategory
TypeCodeableConcept
Must Supporttrue
Requirements

Allows goals to be filtered and sorted.

Goal.description
Definition

Human-readable description of a specific desired objective of care.

Control1..1
Typestring
Requirements

Without a description of what's trying to be achieved, element has no purpose.

Goal.status
Definition

Indicates whether the goal has been reached and is still considered relevant.

Control1..1
BindingIndicates whether the goal has been met and is still being targeted
The codes SHALL be taken from GoalStatus
Typecode
Is Modifiertrue
Must Supporttrue
Requirements

Allows measuring outcome and whether goal needs to be further tracked.

Goal.statusDate
Definition

Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc.

Control0..1
Typedate
Must Supporttrue
Comments

To see the date for past statuses, query history.

Goal.statusReason
Definition

Captures the reason for the current status.

Control0..1
BindingCodes to identify the reason for a goal's current status
For example codes, see GoalStatusReason
TypeCodeableConcept
Comments

This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others.

Goal.author
Definition

Indicates whose goal this is - patient goal, practitioner goal, etc.

Control0..1
TypeChoice of: Reference(Patient), Reference(Practitioner), Reference(RelatedPerson)
Comments

This is the individual reponsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.).

Goal.priority
Definition

Identifies the mutually agreed level of importance associated with reaching/sustaining the goal.

Control0..1
BindingThe level of importance associated with a goal
The codes SHOULD be taken from GoalPriority
TypeCodeableConcept
Requirements

Used for sorting and presenting goals.

Comments

Extensions are available to track priorities as established by each participant (i.e. Priority from the patient's perspective, different practitioners' perspectives, family member's perspectives)

The ordinal extension on Coding can be used to convey a numerically comparable ranking to priority. (Keep in mind that different coding systems may use a "low value=important".

Goal.addresses
Definition

The identified conditions and other health record elements that are intended to be addressed by the goal.

Control0..*
TypeChoice of: Reference(QICore-Condition), Reference(QICore-Observation), Reference(QICore-MedicationStatement), Reference(NutritionOrder), Reference(QICore-ProcedureRequest), Reference(RiskAssessment)
Must Supporttrue
Requirements

Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable.

Goal.note
Definition

Any comments related to the goal.

Control0..*
TypeAnnotation
Requirements

There's a need to capture information about the goal that doesn't actually describe the goal.

Comments

May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.

Goal.outcome
Definition

Identifies the change (or lack of change) at the point where the goal was deepmed to be cancelled or achieved.

Control0..*
TypeBackboneElement
Requirements

Outcome tracking is a key aspect of care planning.

Comments

Note that this should not duplicate the goal status.

Goal.outcome.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Goal.outcome.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

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.

Goal.outcome.modifierExtension
Definition

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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
Comments

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.

Goal.outcome.result[x]
Definition

Details of what's changed (or not changed).

Control0..1
BindingThe result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months"
TypeChoice of: CodeableConcept, Reference(Observation)
[x] NoteSee Choice of Data Types for further information about how to use [x]