HL7 FHIR® US Core Implementation Guide (Release 3.0.1 STU3 Update for Comment)

This page is part of the US Core (v3.0.1: STU3 Ballot 3) based on FHIR R4. The current version which supercedes this version is 5.0.1. For a full list of available versions, see the Directory of published versions

StructureDefinition-us-core-goal

This profile sets minimum expectations for the Goal resource to record, search and fetch Goal information associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the US Core-Goal profile:

  • Query for a Patient’s Goals
  • Record or update a Patient’s Goals

Mandatory and Must Support Data Elements

The following data-elements are mandatory (i.e data MUST be present) or must be supported if the data is present in the sending system ([Must Support] definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The [Formal Profile Definition] below provides the formal summary, definitions, and terminology requirements.

Each Goal must have:

  1. a status
  2. text description of the goal
  3. a patient

Each Goal must support:

  1. target date(s):

Profile specific implementation guidance:

  • none

Examples

Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal

Published on Tue May 21 00:00:00 EDT 2019 as active by the HL7 US Realm Steering Committee.

This profile builds on Goal

Goal

Summary of the Mandatory Requirements

  1. A code in Goal.lifecycleStatus with a required binding to GoalLifecycleStatus
  2. A CodeableConcept in Goal.description with an example binding to SNOMED CT Clinical Findings
  3. A Patient Reference in Goal.subject

Summary of the Must Support Requirements

  1. One or more Targets in Goal.target with the following constraints: Goal.target.measure is required if Goal.target.detail is populated
    • which should have a date value in Goal.target.dueDate

Summary of Constraints

  1. Goal.target.measure is required if Goal.target.detail is populated
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal I0..*Describes the intended objective(s) for a patient, group or organization
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal Ids for this goal
... lifecycleStatus ?!SΣ1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred)
... category Σ0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example)
... priority Σ0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred)
... description SΣ1..1CodeableConceptCode or text describing goal
Binding: SNOMEDCTClinicalFindings (example)
... subject SΣ1..1Reference(US Core Patient Profile)Who this goal is intended for
... start[x] Σ0..1When goal pursuit begins
Binding: GoalStartEvent (example)
.... startDatedate
.... startCodeableConceptCodeableConcept
... target SI0..*BackboneElementTarget outcome for the goal
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure ΣI0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example)
.... detail[x] ΣI0..1The target value to be achieved
Binding: (unbound) (example)
..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] Σ0..1(Slice Definition)Reach goal on or before
Slice: Unordered, Closed by type:$this
..... due[x]:dueDate SΣ0..1dateReach goal on or before
... statusDate Σ0..1dateWhen goal status took effect
... statusReason 0..1stringReason for current status
... expressedBy Σ0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)Who's responsible for creating Goal?
... addresses 0..*Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)Issues addressed by this goal
... note 0..*AnnotationComments about the goal
... outcomeCode 0..*CodeableConceptWhat result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (example)
... outcomeReference 0..*Reference(Observation)Observation that resulted from goal

doco Documentation for this format

Goal

Summary of the Mandatory Requirements

  1. A code in Goal.lifecycleStatus with a required binding to GoalLifecycleStatus
  2. A CodeableConcept in Goal.description with an example binding to SNOMED CT Clinical Findings
  3. A Patient Reference in Goal.subject

Summary of the Must Support Requirements

  1. One or more Targets in Goal.target with the following constraints: Goal.target.measure is required if Goal.target.detail is populated
    • which should have a date value in Goal.target.dueDate

Summary of Constraints

  1. Goal.target.measure is required if Goal.target.detail is populated

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal I0..*Describes the intended objective(s) for a patient, group or organization
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal Ids for this goal
... lifecycleStatus ?!SΣ1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred)
... category Σ0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example)
... priority Σ0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred)
... description SΣ1..1CodeableConceptCode or text describing goal
Binding: SNOMEDCTClinicalFindings (example)
... subject SΣ1..1Reference(US Core Patient Profile)Who this goal is intended for
... start[x] Σ0..1When goal pursuit begins
Binding: GoalStartEvent (example)
.... startDatedate
.... startCodeableConceptCodeableConcept
... target SI0..*BackboneElementTarget outcome for the goal
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure ΣI0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example)
.... detail[x] ΣI0..1The target value to be achieved
Binding: (unbound) (example)
..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] Σ0..1(Slice Definition)Reach goal on or before
Slice: Unordered, Closed by type:$this
..... due[x]:dueDate SΣ0..1dateReach goal on or before
... statusDate Σ0..1dateWhen goal status took effect
... statusReason 0..1stringReason for current status
... expressedBy Σ0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)Who's responsible for creating Goal?
... addresses 0..*Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)Issues addressed by this goal
... note 0..*AnnotationComments about the goal
... outcomeCode 0..*CodeableConceptWhat result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (example)
... outcomeReference 0..*Reference(Observation)Observation that resulted from goal

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron


Quick Start

Below is an overview of the required set of RESTful FHIR interactions - for example, search and read operations - for this profile. See the Conformance requirements for a complete list of supported RESTful interactions for this IG.

  • See the General Guidance section for additional rules and expectations when a server requires status parameters.
  • See the General Guidance section for additional guidance on searching for multiple patients.

Mandatory Search Parameters:

The following search parameters, search parameter combinations SHALL be supported. Any listed search parameter modifiers, comparators, chains and composites SHALL also be supported UNLESS they are listed as “optional” in which case they SHOULD be supported.:

  1. SHALL support searching for all goals for a patient using the patient search parameter:

    GET [base]/Goal?patient=[reference]

    Example:

    1. GET [base]/Goal?patient=1137192

    Implementation Notes: Fetches a bundle of all Goal resources for the specified patient (how to search by reference)

Optional Search Parameters:

The following search parameters, search parameter combinations and search parameter modifiers, comparators, chains and composites SHOULD be supported.

  1. SHOULD support searching using the combination of the patient and lifecycle-status search parameters:

    GET [base]/Goal?patient=[reference]&lifecycle-status={[system]}|[code]

    Example:

    1. GET [base]/Goal?patient=1137192&lifecycle-status=active

    Implementation Notes: Fetches a bundle of all Goal resources for the specified patient and lifecycle-status (how to search by reference and how to search by token)

  2. SHOULD support searching using the combination of the patient and target-date search parameters:

    • including support for these target-date comparators: gt,lt,ge,le
    • including optional support for composite AND search on target-date (e.g.target-date=[date]&target-date=[date]]&...)

    GET [base]/Goal?patient=[reference]&target-date={gt|lt|ge|le}[date]{&target-date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/Goal?patient=1137192&target-date=ge2015-01-14&target-date=le2019-01-14

    Implementation Notes: Fetches a bundle of all Goal resources for the specified patient and target-date (how to search by reference and how to search by date)