Scope and Usage

Purpose of the resource

The purpose of the Personal Functioning and Engagement Goal Profile is to facilitate exchange between post-acute care and other health care settings of personal functioning and engagement goals for post-acute care patients. For this profile, “post-acute care” is defined as “care that is provided to individuals who need additional help recuperating from an acute illness or serious medical procedure” cite; “personal” is defined as relating to an individual person, as opposed to a group, system, or organization; “functioning” is defined as what the person can do, the help they need, and the effects of contributing factors, including physiological, environmental, and personal conditions and encompasses body functions, activities, and participation cite; “engagement” is defined as participating in one’s life, as opposed to being a passive observer.

What is in this resource

The Personal Functioning and Engagement Goal Profile includes data elements for patient personal functioning and engagement goals regarding:

• Descriptive information about the goal, including what the goal is, the current status of implementing the goal, the start date of when the patient starts work on the goal, and the status of the patient’s achievement of the goal,
• The target outcome for the goal, including a measure for assessing the goal and the date to reach the target, and
• The patient issues addressed by the goal.

Intended audience and setting for the resource

This resource has been developed for healthcare providers who are involved with supporting post-acute patients’ personal functioning and engagement goals, such as physicians, nurse practitioners, physical therapists, and speech language pathologists/therapists as well as EHR implementers. It accommodates the variety of scopes of practice by different disciplines that can be involved in setting, implementing, and evaluating a patient’s goal. The profile was developed for post-acute care settings, such as skilled nursing facilities and home health, and can also be used in acute care settings.

What the resource can be used for

This resource can be used by post-acute care facilities, as well as acute care hospitals, to support data entry around goal planning, implementation, and evaluation. It supports input and updates from multiple healthcare providers.

Example of the Goals resource supporting documentation of a palliative care goal for a patient provided by a home-based palliative care provider which has implemented the resource into their electronic health record (EHR): A patient who has recently enrolled in home hospice indicates to their home health nurse that they would like to be well enough to attend their daughter’s wedding happening in 5 months in a neighboring town. After discussing the goal with the patient, the home health nurse uses her laptop to document the patient’s goal into the EHR, which was updated recently to include options for her to enter information included in the Personal Functioning and Engagement Goals profile. Later, the physician overseeing the care of the patient reads the new information about the patient’s goals and is able to share that information with another healthcare provider outside their organization who provides specialized treatment the patient needs to reach their goal. Together, the physician and the specialty provider, as well as the home health nurse and others in the patient’s care team, develop a care plan to support the patient’s goal.

How this resource was developed

The Personal Functioning and Engagement Goal Profile was developed by the Personal Functioning and Engagement subgroup of the Post-Acute Care InterOperability (PACIO) project. The subgroup contained experts in: supporting patients’ nutrition and diet (e.g., physical therapists, speech language pathologists), EHR implementation and interoperability, HL7 FHIR, and user-centered design. PACIO is sponsored by the US Centers for Medicare and Medicaid Services (CMS) and by the MITRE Corporation.

Boundaries and Relationships

Within boundaries/scope of the resource

The scope of the Personal Functioning and Engagement Goal Profile encompasses a patient's goal regarding their personal functioning and engagement.

Other resources that address related content outside the boundaries/scope of this resource

Goals are typically established in the context of a CarePlan, and are sometimes evaluated using Observations. A Personal Functioning and Engagement Goal may be evaluated using a Personal Functioning and Engagement Goal Single Observation.

Relationship to other resources

This profile is derived from the US Core Goal profile. Within the Personal Functioning and Engagement Goal profile, the addresses data element is still optional, but it was elevated to Must Support. This data element is a reference to an instance of Condition, Observation, MedicationStatement, NutritionOrder, ServiceRequest, or RiskAssessment.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Goal		0..*	USCoreGoalProfile(6.1.0)	Describes the intended objective(s) for a patient, group or organization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
lifecycleStatus	?!SΣ	1..1	code	(USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required)
achievementStatus	SΣ	0..1	CodeableConcept	in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Binding: GoalAchievementStatus (extensible)
description	SΣ	1..1	CodeableConcept	(USCDI) Code or text describing goal Binding: US Core Goal Codes (extensible): Value set to describe the Goal
subject	SΣ	1..1	Reference(US Core Patient Profile(6.1.0))	(USCDI) Who this goal is intended for
start[x]	SΣ	0..1		(USCDI) When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate			date S
startCodeableConcept			CodeableConcept
target	SC	0..*	BackboneElement	(USCDI) Target outcome for the goal Constraints: gol-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
due[x]	SΣ	0..1		(USCDI) Reach goal on or before
dueDate			date S
dueDuration			Duration
expressedBy	SΣ	0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)	Who's responsible for creating Goal?
addresses	S	0..*	Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)	Issues addressed by this goal
note	S	0..*	Annotation	Comments about the goal
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Goal.lifecycleStatus	required	GoalLifecycleStatus http://hl7.org/fhir/ValueSet/goal-status From the FHIR Standard
Goal.achievementStatus	extensible	GoalAchievementStatus http://hl7.org/fhir/ValueSet/goal-achievement From the FHIR Standard
Goal.description	extensible	USCoreGoalCodes http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]	example	GoalStartEvent http://hl7.org/fhir/ValueSet/goal-start-event From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Goal	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Goal	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Goal	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Goal	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Goal	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
gol-1	error	Goal.target	Goal.target.measure is required if Goal.target.detail is populated : (detail.exists() and measure.exists()) or detail.exists().not()

This structure is derived from USCoreGoalProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Goal		0..*	USCoreGoalProfile(6.1.0)	Describes the intended objective(s) for a patient, group or organization
achievementStatus	S	0..1	CodeableConcept	in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Binding: GoalAchievementStatus (extensible)
expressedBy	S	0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)	Who's responsible for creating Goal?
addresses	S	0..*	Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)	Issues addressed by this goal
note	S	0..*	Annotation	Comments about the goal
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Goal.achievementStatus	extensible	GoalAchievementStatus http://hl7.org/fhir/ValueSet/goal-achievement From the FHIR Standard

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Goal		0..*	USCoreGoalProfile(6.1.0)	Describes the intended objective(s) for a patient, group or organization
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External Ids for this goal
lifecycleStatus	?!SΣ	1..1	code	(USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required)
achievementStatus	SΣ	0..1	CodeableConcept	in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Binding: GoalAchievementStatus (extensible)
category	Σ	0..*	CodeableConcept	E.g. Treatment, dietary, behavioral, etc. Binding: GoalCategory (example): Codes for grouping and sorting goals.
priority	Σ	0..1	CodeableConcept	high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal.
description	SΣ	1..1	CodeableConcept	(USCDI) Code or text describing goal Binding: US Core Goal Codes (extensible): Value set to describe the Goal
subject	SΣ	1..1	Reference(US Core Patient Profile(6.1.0))	(USCDI) Who this goal is intended for
start[x]	SΣ	0..1		(USCDI) When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate			date S
startCodeableConcept			CodeableConcept
target	SC	0..*	BackboneElement	(USCDI) Target outcome for the goal Constraints: gol-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
measure	ΣC	0..1	CodeableConcept	The parameter whose value is being tracked Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
detail[x]	ΣC	0..1		The target value to be achieved Binding Description: (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.
detailQuantity			Quantity
detailRange			Range
detailCodeableConcept			CodeableConcept
detailString			string
detailBoolean			boolean
detailInteger			integer
detailRatio			Ratio
due[x]	SΣ	0..1		(USCDI) Reach goal on or before
dueDate			date S
dueDuration			Duration
statusDate	Σ	0..1	date	When goal status took effect
statusReason		0..1	string	Reason for current status
expressedBy	SΣ	0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)	Who's responsible for creating Goal?
addresses	S	0..*	Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)	Issues addressed by this goal
note	S	0..*	Annotation	Comments about the goal
outcomeCode		0..*	CodeableConcept	What result was achieved regarding the goal? Binding: SNOMEDCTClinicalFindings (example): 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".
outcomeReference		0..*	Reference(Observation)	Observation that resulted from goal
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Goal.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Goal.lifecycleStatus	required	GoalLifecycleStatus http://hl7.org/fhir/ValueSet/goal-status From the FHIR Standard
Goal.achievementStatus	extensible	GoalAchievementStatus http://hl7.org/fhir/ValueSet/goal-achievement From the FHIR Standard
Goal.category	example	GoalCategory http://hl7.org/fhir/ValueSet/goal-category From the FHIR Standard
Goal.priority	preferred	GoalPriority http://hl7.org/fhir/ValueSet/goal-priority From the FHIR Standard
Goal.description	extensible	USCoreGoalCodes http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]	example	GoalStartEvent http://hl7.org/fhir/ValueSet/goal-start-event From the FHIR Standard
Goal.target.measure	example	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From the FHIR Standard
Goal.target.detail[x]	example
Goal.outcomeCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Goal	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Goal	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Goal	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Goal	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Goal	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
gol-1	error	Goal.target	Goal.target.measure is required if Goal.target.detail is populated : (detail.exists() and measure.exists()) or detail.exists().not()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Goal		0..*	USCoreGoalProfile(6.1.0)	Describes the intended objective(s) for a patient, group or organization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
lifecycleStatus	?!SΣ	1..1	code	(USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required)
achievementStatus	SΣ	0..1	CodeableConcept	in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Binding: GoalAchievementStatus (extensible)
description	SΣ	1..1	CodeableConcept	(USCDI) Code or text describing goal Binding: US Core Goal Codes (extensible): Value set to describe the Goal
subject	SΣ	1..1	Reference(US Core Patient Profile(6.1.0))	(USCDI) Who this goal is intended for
start[x]	SΣ	0..1		(USCDI) When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate			date S
startCodeableConcept			CodeableConcept
target	SC	0..*	BackboneElement	(USCDI) Target outcome for the goal Constraints: gol-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
due[x]	SΣ	0..1		(USCDI) Reach goal on or before
dueDate			date S
dueDuration			Duration
expressedBy	SΣ	0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)	Who's responsible for creating Goal?
addresses	S	0..*	Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)	Issues addressed by this goal
note	S	0..*	Annotation	Comments about the goal
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Goal.lifecycleStatus	required	GoalLifecycleStatus http://hl7.org/fhir/ValueSet/goal-status From the FHIR Standard
Goal.achievementStatus	extensible	GoalAchievementStatus http://hl7.org/fhir/ValueSet/goal-achievement From the FHIR Standard
Goal.description	extensible	USCoreGoalCodes http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]	example	GoalStartEvent http://hl7.org/fhir/ValueSet/goal-start-event From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Goal	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Goal	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Goal	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Goal	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Goal	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
gol-1	error	Goal.target	Goal.target.measure is required if Goal.target.detail is populated : (detail.exists() and measure.exists()) or detail.exists().not()

Differential View

This structure is derived from USCoreGoalProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Goal		0..*	USCoreGoalProfile(6.1.0)	Describes the intended objective(s) for a patient, group or organization
achievementStatus	S	0..1	CodeableConcept	in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Binding: GoalAchievementStatus (extensible)
expressedBy	S	0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)	Who's responsible for creating Goal?
addresses	S	0..*	Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)	Issues addressed by this goal
note	S	0..*	Annotation	Comments about the goal
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Goal.achievementStatus	extensible	GoalAchievementStatus http://hl7.org/fhir/ValueSet/goal-achievement From the FHIR Standard

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Goal		0..*	USCoreGoalProfile(6.1.0)	Describes the intended objective(s) for a patient, group or organization
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External Ids for this goal
lifecycleStatus	?!SΣ	1..1	code	(USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required)
achievementStatus	SΣ	0..1	CodeableConcept	in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Binding: GoalAchievementStatus (extensible)
category	Σ	0..*	CodeableConcept	E.g. Treatment, dietary, behavioral, etc. Binding: GoalCategory (example): Codes for grouping and sorting goals.
priority	Σ	0..1	CodeableConcept	high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal.
description	SΣ	1..1	CodeableConcept	(USCDI) Code or text describing goal Binding: US Core Goal Codes (extensible): Value set to describe the Goal
subject	SΣ	1..1	Reference(US Core Patient Profile(6.1.0))	(USCDI) Who this goal is intended for
start[x]	SΣ	0..1		(USCDI) When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate			date S
startCodeableConcept			CodeableConcept
target	SC	0..*	BackboneElement	(USCDI) Target outcome for the goal Constraints: gol-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
measure	ΣC	0..1	CodeableConcept	The parameter whose value is being tracked Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
detail[x]	ΣC	0..1		The target value to be achieved Binding Description: (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.
detailQuantity			Quantity
detailRange			Range
detailCodeableConcept			CodeableConcept
detailString			string
detailBoolean			boolean
detailInteger			integer
detailRatio			Ratio
due[x]	SΣ	0..1		(USCDI) Reach goal on or before
dueDate			date S
dueDuration			Duration
statusDate	Σ	0..1	date	When goal status took effect
statusReason		0..1	string	Reason for current status
expressedBy	SΣ	0..1	Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)	Who's responsible for creating Goal?
addresses	S	0..*	Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)	Issues addressed by this goal
note	S	0..*	Annotation	Comments about the goal
outcomeCode		0..*	CodeableConcept	What result was achieved regarding the goal? Binding: SNOMEDCTClinicalFindings (example): 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".
outcomeReference		0..*	Reference(Observation)	Observation that resulted from goal
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Goal.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Goal.lifecycleStatus	required	GoalLifecycleStatus http://hl7.org/fhir/ValueSet/goal-status From the FHIR Standard
Goal.achievementStatus	extensible	GoalAchievementStatus http://hl7.org/fhir/ValueSet/goal-achievement From the FHIR Standard
Goal.category	example	GoalCategory http://hl7.org/fhir/ValueSet/goal-category From the FHIR Standard
Goal.priority	preferred	GoalPriority http://hl7.org/fhir/ValueSet/goal-priority From the FHIR Standard
Goal.description	extensible	USCoreGoalCodes http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]	example	GoalStartEvent http://hl7.org/fhir/ValueSet/goal-start-event From the FHIR Standard
Goal.target.measure	example	LOINCCodes(a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes From the FHIR Standard
Goal.target.detail[x]	example
Goal.outcomeCode	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Goal	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Goal	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Goal	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Goal	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Goal	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
gol-1	error	Goal.target	Goal.target.measure is required if Goal.target.detail is populated : (detail.exists() and measure.exists()) or detail.exists().not()

This structure is derived from USCoreGoalProfile

Summary

Must-Support: 4 elements

Maturity: 3