Release 5 Preview #3
Clinical SummaryThis page is part of the FHIR Specification (v4.5.0: R5 Preview #3). 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
| 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:
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 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.
This resource does not implement any patterns.
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  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 | |
 lifecycleStatus | ?!Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected GoalLifecycleStatus (Required) |
| achievementStatus | Σ | 0..1 | CodeableConcept | in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Goal achievement status (Preferred) |
| category | Σ | 0..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. 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 Goal priority (Preferred) |
| description | Σ | 1..1 | CodeableConcept | Code or text describing goal SNOMED CT Clinical Findings (Example) |
 subject | Σ | 1..1 | Reference(Patient | Group | Organization) | Who this goal is intended for |
  start[x] | Σ | 0..1 | When goal pursuit begins Goal start event (Example) | |
 startDate | date | |||
 startCodeableConcept | CodeableConcept | |||
 target | I | 0..* | BackboneElement | Target outcome for the goal + Rule: Goal.target.measure is required if Goal.target.detail is populated |
| measure | ΣI | 0..1 | CodeableConcept | The parameter whose value is being tracked LOINC Codes (Example) |
| detail[x] | ΣI | 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 | MedicationUsage | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment) | Issues addressed by this goal | |
| note | 0..* | Annotation | Comments about the goal | |
| outcome | 0..* | CodeableReference(Observation) | What result was achieved regarding the goal? SNOMED CT Clinical Findings (Example) | |
| Documentation for this format | ||||
UML Diagram (Legend)
XML Template
<Goal xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <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><!-- 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><!--
JSON Template
{
"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
"outcome" : [{ CodeableReference(Observation) }] // What result was achieved regarding the goal?
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since R3
| Goal | |
| Goal.lifecycleStatus |
|
| Goal.continuous |
|
| Goal.addresses |
|
| Goal.outcome |
|
| Goal.outcomeCode |
|
| Goal.outcomeReference |
|
See the Full Difference for further information
This analysis is available as XML or JSON.
See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.)
Structure
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| 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 | |
| lifecycleStatus | ?!Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected GoalLifecycleStatus (Required) |
| achievementStatus | Σ | 0..1 | CodeableConcept | in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Goal achievement status (Preferred) |
| category | Σ | 0..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. 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 Goal priority (Preferred) |
| description | Σ | 1..1 | CodeableConcept | Code or text describing goal SNOMED CT Clinical Findings (Example) |
| subject | Σ | 1..1 | Reference(Patient | Group | Organization) | Who this goal is intended for |
| start[x] | Σ | 0..1 | When goal pursuit begins Goal start event (Example) | |
| startDate | date | |||
| startCodeableConcept | CodeableConcept | |||
| target | I | 0..* | BackboneElement | Target outcome for the goal + Rule: Goal.target.measure is required if Goal.target.detail is populated |
| measure | ΣI | 0..1 | CodeableConcept | The parameter whose value is being tracked LOINC Codes (Example) |
| detail[x] | ΣI | 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 | MedicationUsage | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment) | Issues addressed by this goal | |
| note | 0..* | Annotation | Comments about the goal | |
| outcome | 0..* | CodeableReference(Observation) | What result was achieved regarding the goal? SNOMED CT Clinical Findings (Example) | |
| Documentation for this format | ||||
XML Template
<Goal xmlns="http://hl7.org/fhir">
JSON Template
{
"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
"outcome" : [{ CodeableReference(Observation) }] // What result was achieved regarding the goal?
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .
Changes since Release 3
| Goal | |
| Goal.lifecycleStatus |
|
| Goal.continuous |
|
| Goal.addresses |
|
| Goal.outcome |
|
| Goal.outcomeCode |
|
| Goal.outcomeReference |
|
See the Full Difference for further information
This analysis is available as XML or JSON.
See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.)
See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis a
| Path | Definition | Type | Reference |
|---|---|---|---|
| Goal.lifecycleStatus | Codes that reflect the current state of a goal and whether the goal is still being targeted. | Required | 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. | Example | GoalCategory |
| Goal.priority | The level of importance associated with a 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 | SNOMEDCTClinicalFindings |
| Goal.start[x] | Codes describing events that can trigger the initiation of a goal. | Example | GoalStartEvent |
| Goal.target.measure | Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. | Example | 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.outcome | 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". | Example | SNOMEDCTClinicalFindings |
| id | Level | Location | Description | Expression |
| gol-1 | Rule | Goal.target | Goal.target.measure is required if Goal.target.detail is populated | (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 | 30 Resources |
| lifecycle-status N | 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.where(resolve() is Patient) (Patient) | 33 Resources |
| start-date | date | When goal pursuit begins | (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) |
FHIR ®© HL7.org 2011+. FHIR R5 Preview #3 hl7.fhir.core#4.5.0 generated on Thu, Aug 20, 2020 17:45+1000.
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