QI-Core Implementation Guide
5.0.0 - STU5 United States of America flag

This page is part of the Quality Improvement Core Framework (v5.0.0: STU5 (v5.0.0)) based on FHIR R4. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

Resource Profile: QICore Goal

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-goal Version: 5.0.0
Active as of 2018-08-22 Computable Name: QICoreGoal

Profile of Goal for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

See the patterns page for implementation and usage patterns.

Examples

Weight Loss Example

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreGoalProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... reasonRejected 0..1CodeableConceptThe reason the goal was not accepted
URL: http://hl7.org/fhir/StructureDefinition/goal-reasonRejected
Binding: QICore Reasons Rejecting Goal (example): The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support the goal process, in particular the process and reasons for rejecting a goal. This value set is provided as a suggestive example.

... achievementStatus S0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
... category S0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (preferred): Codes for grouping and sorting goals.

... start[x] 0..1dateWhen goal pursuit begins
... target S0..*BackboneElementTarget outcome for the goal
.... measure S1..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (preferred): LOINC codes

.... detail[x] S1..1Quantity, Range, CodeableConcept, string, boolean, integer, RatioThe target value to be achieved
... statusDate S0..1dateWhen goal status took effect
... expressedBy 0..1Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson)Who's responsible for creating Goal?
... addresses S0..*Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Observation | QICore MedicationStatement | QICore NutritionOrder | QICore ServiceRequest | RiskAssessment)Issues addressed by this goal

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Goal.extension:reasonRejected
[CanonicalType[http://hl7.org/fhir/StructureDefinition/goal-reasonRejected]]
exampleQICoreGoalReasonRejected
Goal.categorypreferredGoalCategory
Goal.target.measurepreferredLOINCCodes (a valid code from LOINC)
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... reasonRejected 0..1CodeableConceptThe reason the goal was not accepted
URL: http://hl7.org/fhir/StructureDefinition/goal-reasonRejected
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... achievementStatus SΣ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.

... category SΣ0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (preferred): Codes for grouping and sorting goals.


... description SΣ1..1CodeableConceptCode or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal

... subject SΣ1..1Reference(QICore Patient)Who this goal is intended for
... start[x] Σ0..1dateWhen goal pursuit begins
... target SC0..*BackboneElementTarget outcome for the goal
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure SΣC1..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (preferred): LOINC codes

.... detail[x] SΣC1..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] SΣ0..1Reach goal on or before
..... dueDatedate
... statusDate SΣ0..1dateWhen goal status took effect
... expressedBy Σ0..1Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson)Who's responsible for creating Goal?
... addresses S0..*Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Observation | QICore MedicationStatement | QICore NutritionOrder | QICore ServiceRequest | RiskAssessment)Issues addressed by this goal

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Goal.lifecycleStatusrequiredGoalLifecycleStatus
Goal.achievementStatuspreferredGoalAchievementStatus
Goal.categorypreferredGoalCategory
Goal.descriptionextensibleUSCoreGoalCodes
Goal.target.measurepreferredLOINCCodes (a valid code from LOINC)
Goal.target.detail[x]example

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorGoalIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorGoalIf 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-4errorGoalIf 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-5errorGoalIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceGoalA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gol-1errorGoal.targetGoal.target.measure is required if Goal.target.detail is populated
: (detail.exists() and measure.exists()) or detail.exists().not()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes 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
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... reasonRejected 0..1CodeableConceptThe reason the goal was not accepted
URL: http://hl7.org/fhir/StructureDefinition/goal-reasonRejected
... 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 SΣ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.

... category SΣ0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (preferred): Codes for grouping and sorting goals.


... priority Σ0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): The level of importance associated with a goal.

... description SΣ1..1CodeableConceptCode or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal

... subject SΣ1..1Reference(QICore Patient)Who this goal is intended for
... start[x] Σ0..1dateWhen goal pursuit begins
... target SC0..*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 SΣC1..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (preferred): LOINC codes

.... detail[x] SΣC1..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] SΣ0..1Reach goal on or before
..... dueDatedate S
..... dueDurationDuration
... statusDate SΣ0..1dateWhen goal status took effect
... statusReason 0..1stringReason for current status
... expressedBy Σ0..1Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson)Who's responsible for creating Goal?
... addresses S0..*Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Observation | QICore MedicationStatement | QICore NutritionOrder | QICore 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): 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Goal.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Goal.lifecycleStatusrequiredGoalLifecycleStatus
Goal.achievementStatuspreferredGoalAchievementStatus
Goal.categorypreferredGoalCategory
Goal.prioritypreferredGoalPriority
Goal.descriptionextensibleUSCoreGoalCodes
Goal.target.measurepreferredLOINCCodes (a valid code from LOINC)
Goal.target.detail[x]example
Goal.outcomeCodeexampleSNOMEDCTClinicalFindings

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gol-1errorGoal.targetGoal.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

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... reasonRejected 0..1CodeableConceptThe reason the goal was not accepted
URL: http://hl7.org/fhir/StructureDefinition/goal-reasonRejected
Binding: QICore Reasons Rejecting Goal (example): The value set to instantiate this attribute should be drawn from a terminologically robust code system that consists of or contains concepts to support the goal process, in particular the process and reasons for rejecting a goal. This value set is provided as a suggestive example.

... achievementStatus S0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
... category S0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (preferred): Codes for grouping and sorting goals.

... start[x] 0..1dateWhen goal pursuit begins
... target S0..*BackboneElementTarget outcome for the goal
.... measure S1..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (preferred): LOINC codes

.... detail[x] S1..1Quantity, Range, CodeableConcept, string, boolean, integer, RatioThe target value to be achieved
... statusDate S0..1dateWhen goal status took effect
... expressedBy 0..1Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson)Who's responsible for creating Goal?
... addresses S0..*Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Observation | QICore MedicationStatement | QICore NutritionOrder | QICore ServiceRequest | RiskAssessment)Issues addressed by this goal

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Goal.extension:reasonRejected
[CanonicalType[http://hl7.org/fhir/StructureDefinition/goal-reasonRejected]]
exampleQICoreGoalReasonRejected
Goal.categorypreferredGoalCategory
Goal.target.measurepreferredLOINCCodes (a valid code from LOINC)

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... reasonRejected 0..1CodeableConceptThe reason the goal was not accepted
URL: http://hl7.org/fhir/StructureDefinition/goal-reasonRejected
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... achievementStatus SΣ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.

... category SΣ0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (preferred): Codes for grouping and sorting goals.


... description SΣ1..1CodeableConceptCode or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal

... subject SΣ1..1Reference(QICore Patient)Who this goal is intended for
... start[x] Σ0..1dateWhen goal pursuit begins
... target SC0..*BackboneElementTarget outcome for the goal
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure SΣC1..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (preferred): LOINC codes

.... detail[x] SΣC1..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] SΣ0..1Reach goal on or before
..... dueDatedate
... statusDate SΣ0..1dateWhen goal status took effect
... expressedBy Σ0..1Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson)Who's responsible for creating Goal?
... addresses S0..*Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Observation | QICore MedicationStatement | QICore NutritionOrder | QICore ServiceRequest | RiskAssessment)Issues addressed by this goal

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Goal.lifecycleStatusrequiredGoalLifecycleStatus
Goal.achievementStatuspreferredGoalAchievementStatus
Goal.categorypreferredGoalCategory
Goal.descriptionextensibleUSCoreGoalCodes
Goal.target.measurepreferredLOINCCodes (a valid code from LOINC)
Goal.target.detail[x]example

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorGoalIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorGoalIf 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-4errorGoalIf 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-5errorGoalIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceGoalA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gol-1errorGoal.targetGoal.target.measure is required if Goal.target.detail is populated
: (detail.exists() and measure.exists()) or detail.exists().not()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes 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
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... reasonRejected 0..1CodeableConceptThe reason the goal was not accepted
URL: http://hl7.org/fhir/StructureDefinition/goal-reasonRejected
... 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 SΣ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.

... category SΣ0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (preferred): Codes for grouping and sorting goals.


... priority Σ0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): The level of importance associated with a goal.

... description SΣ1..1CodeableConceptCode or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal

... subject SΣ1..1Reference(QICore Patient)Who this goal is intended for
... start[x] Σ0..1dateWhen goal pursuit begins
... target SC0..*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 SΣC1..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (preferred): LOINC codes

.... detail[x] SΣC1..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] SΣ0..1Reach goal on or before
..... dueDatedate S
..... dueDurationDuration
... statusDate SΣ0..1dateWhen goal status took effect
... statusReason 0..1stringReason for current status
... expressedBy Σ0..1Reference(QICore Patient | QICore Practitioner | QICore RelatedPerson)Who's responsible for creating Goal?
... addresses S0..*Reference(QICore Condition Encounter Diagnosis | QICore Condition Problems Health Concerns | QICore Observation | QICore MedicationStatement | QICore NutritionOrder | QICore 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): 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Goal.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Goal.lifecycleStatusrequiredGoalLifecycleStatus
Goal.achievementStatuspreferredGoalAchievementStatus
Goal.categorypreferredGoalCategory
Goal.prioritypreferredGoalPriority
Goal.descriptionextensibleUSCoreGoalCodes
Goal.target.measurepreferredLOINCCodes (a valid code from LOINC)
Goal.target.detail[x]example
Goal.outcomeCodeexampleSNOMEDCTClinicalFindings

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gol-1errorGoal.targetGoal.target.measure is required if Goal.target.detail is populated
: (detail.exists() and measure.exists()) or detail.exists().not()

 

Other representations of profile: CSV, Excel, Schematron