This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions
Patient Care Work Group | Maturity Level: 2 | Trial Use | Security Category: Patient | Compartments: Patient |
Detailed Descriptions for the elements in the Goal resource.
Goal | |||||||||
Element Id | 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. | ||||||||
Short Display | Describes the intended objective(s) for a patient, group or organization | ||||||||
Cardinality | 0..* | ||||||||
Type | DomainResource | ||||||||
Summary | false | ||||||||
Comments | Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline. | ||||||||
Goal.identifier | |||||||||
Element Id | Goal.identifier | ||||||||
Definition | Business identifiers assigned to this goal by the performer or other systems which remain constant as the resource is updated and propagates from server to server. | ||||||||
Short Display | External Ids for this goal | ||||||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||||||
Cardinality | 0..* | ||||||||
Type | Identifier | ||||||||
Requirements | Allows identification of the goal as it is known by various participating systems and in a way that remains consistent across servers. | ||||||||
Summary | false | ||||||||
Comments | This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. | ||||||||
Goal.lifecycleStatus | |||||||||
Element Id | Goal.lifecycleStatus | ||||||||
Definition | The state of the goal throughout its lifecycle. | ||||||||
Short Display | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected | ||||||||
Cardinality | 1..1 | ||||||||
Terminology Binding | Goal Lifecycle Status (Required) | ||||||||
Type | code | ||||||||
Is Modifier | true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid) | ||||||||
Requirements | Allows knowing whether goal needs to be further tracked. | ||||||||
Summary | true | ||||||||
Comments | This element is labeled as a modifier because the lifecycleStatus contains codes that mark the resource as not currently valid. | ||||||||
Goal.achievementStatus | |||||||||
Element Id | Goal.achievementStatus | ||||||||
Definition | Describes the progression, or lack thereof, towards the goal against the target. | ||||||||
Short Display | in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Goal Achievement Status (Preferred) | ||||||||
Type | CodeableConcept | ||||||||
Summary | true | ||||||||
Goal.category | |||||||||
Element Id | Goal.category | ||||||||
Definition | Indicates a category the goal falls within. | ||||||||
Short Display | E.g. Treatment, dietary, behavioral, etc | ||||||||
Cardinality | 0..* | ||||||||
Terminology Binding | Goal Category (Example) | ||||||||
Type | CodeableConcept | ||||||||
Requirements | Allows goals to be filtered and sorted. | ||||||||
Summary | true | ||||||||
Goal.continuous | |||||||||
Element Id | Goal.continuous | ||||||||
Definition | After meeting the goal, ongoing activity is needed to sustain the goal objective. | ||||||||
Short Display | After meeting the goal, ongoing activity is needed to sustain the goal objective | ||||||||
Cardinality | 0..1 | ||||||||
Type | boolean | ||||||||
Requirements | Allows for a system to programmatically update achievementStatus upon finding evidence the goal has been met. | ||||||||
Summary | false | ||||||||
Comments | For example, getting a yellow fever vaccination for a planned trip is a goal that is designed to be completed (continuous = false). A goal to sustain HbA1c levels would not be a one-time goal (continuous = true). | ||||||||
Goal.priority | |||||||||
Element Id | Goal.priority | ||||||||
Definition | Identifies the mutually agreed level of importance associated with reaching/sustaining the goal. | ||||||||
Short Display | high-priority | medium-priority | low-priority | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Goal Priority (Preferred) | ||||||||
Type | CodeableConcept | ||||||||
Requirements | Used for sorting and presenting goals. | ||||||||
Summary | true | ||||||||
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.description | |||||||||
Element Id | Goal.description | ||||||||
Definition | 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". | ||||||||
Short Display | Code or text describing goal | ||||||||
Cardinality | 1..1 | ||||||||
Terminology Binding | Goal Description (Example) | ||||||||
Type | CodeableConcept | ||||||||
Requirements | Without a description of what's trying to be achieved, element has no purpose. | ||||||||
Summary | true | ||||||||
Comments | If no code is available, use CodeableConcept.text. | ||||||||
Goal.subject | |||||||||
Element Id | Goal.subject | ||||||||
Definition | Identifies the patient, group or organization for whom the goal is being established. | ||||||||
Short Display | Who this goal is intended for | ||||||||
Cardinality | 1..1 | ||||||||
Type | Reference(Patient | Group | Organization) | ||||||||
Requirements | Subject is optional to support annonymized reporting. | ||||||||
Summary | true | ||||||||
Goal.start[x] | |||||||||
Element Id | Goal.start[x] | ||||||||
Definition | The date or event after which the goal should begin being pursued. | ||||||||
Short Display | When goal pursuit begins | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | Goal Start Event (Example) | ||||||||
Type | date|CodeableConcept | ||||||||
[x] Note | See Choice of Datatypes 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. | ||||||||
Summary | true | ||||||||
Goal.target | |||||||||
Element Id | Goal.target | ||||||||
Definition | Indicates what should be done by when. | ||||||||
Short Display | Target outcome for the goal | ||||||||
Cardinality | 0..* | ||||||||
Requirements | Allows the progress of the goal to be monitored against an observation or due date. Target is 0..* to support Observations with multiple components, such as blood pressure goals with both a systolic and diastolic target. | ||||||||
Summary | false | ||||||||
Comments | When multiple targets are present for a single goal instance, all targets must be met for the overall goal to be met. | ||||||||
Invariants |
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Goal.target.measure | |||||||||
Element Id | Goal.target.measure | ||||||||
Definition | The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. | ||||||||
Short Display | The parameter whose value is being tracked | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | LOINC Codes (Example) | ||||||||
Type | CodeableConcept | ||||||||
Summary | true | ||||||||
Invariants |
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Goal.target.detail[x] | |||||||||
Element Id | Goal.target.detail[x] | ||||||||
Definition | 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. | ||||||||
Short Display | The target value to be achieved | ||||||||
Cardinality | 0..1 | ||||||||
Terminology Binding | GoalTargetDetail: | ||||||||
Type | Quantity|Range|CodeableConcept|string|boolean|integer|Ratio | ||||||||
[x] Note | See Choice of Datatypes for further information about how to use [x] | ||||||||
Summary | true | ||||||||
Comments | A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Goal.target.measure defines a coded value. | ||||||||
Invariants |
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Goal.target.due[x] | |||||||||
Element Id | Goal.target.due[x] | ||||||||
Definition | Indicates either the date or the duration after start by which the goal should be met. | ||||||||
Short Display | Reach goal on or before | ||||||||
Cardinality | 0..1 | ||||||||
Type | date|Duration | ||||||||
[x] Note | See Choice of Datatypes for further information about how to use [x] | ||||||||
Requirements | Identifies when the goal should be evaluated. | ||||||||
Summary | true | ||||||||
Goal.statusDate | |||||||||
Element Id | Goal.statusDate | ||||||||
Definition | Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc. | ||||||||
Short Display | When goal status took effect | ||||||||
Cardinality | 0..1 | ||||||||
Type | date | ||||||||
Summary | true | ||||||||
Comments | To see the date for past statuses, query history. | ||||||||
Goal.statusReason | |||||||||
Element Id | Goal.statusReason | ||||||||
Definition | Captures the reason for the current status. | ||||||||
Short Display | Reason for current status | ||||||||
Cardinality | 0..1 | ||||||||
Type | string | ||||||||
Summary | false | ||||||||
Comments | This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others. | ||||||||
Goal.source | |||||||||
Element Id | Goal.source | ||||||||
Definition | Indicates whose goal this is - patient goal, practitioner goal, etc. | ||||||||
Short Display | Who's responsible for creating Goal? | ||||||||
Cardinality | 0..1 | ||||||||
Type | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam) | ||||||||
Summary | true | ||||||||
Comments | This is the individual or team responsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.). | ||||||||
Goal.addresses | |||||||||
Element Id | Goal.addresses | ||||||||
Definition | The identified conditions and other resources that provide the context for why the goal exists. | ||||||||
Short Display | Issues addressed by this goal | ||||||||
Cardinality | 0..* | ||||||||
Type | Reference(Condition | Observation | MedicationStatement | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment | Procedure | NutritionIntake) | ||||||||
Requirements | Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable. | ||||||||
Summary | false | ||||||||
Goal.note | |||||||||
Element Id | Goal.note | ||||||||
Definition | Any comments related to the goal. | ||||||||
Short Display | Comments about the goal | ||||||||
Cardinality | 0..* | ||||||||
Type | Annotation | ||||||||
Requirements | There's a need to capture information about the goal that doesn't actually describe the goal. | ||||||||
Summary | false | ||||||||
Comments | May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself. | ||||||||
Goal.outcome | |||||||||
Element Id | Goal.outcome | ||||||||
Definition | Identifies the change (or lack of change) at the point when the status of the goal is assessed. | ||||||||
Short Display | What result was achieved regarding the goal? | ||||||||
Cardinality | 0..* | ||||||||
Terminology Binding | SNOMED CT Clinical Findings (Example) | ||||||||
Type | CodeableReference(Observation) | ||||||||
Requirements | Outcome tracking is a key aspect of care planning. | ||||||||
Summary | false | ||||||||
Comments | Note that this should not duplicate the goal status; The goal outcome is independent of the outcome of the related activities. For example, if the Goal is to achieve a target body weight of 150 lb and a care plan activity is defined to diet, then the care plan’s activity outcome could be calories consumed whereas goal outcome is an observation for the actual body weight measured. |