QI-Core Implementation Guide
7.0.0 - STU 7 United States of America flag

This page is part of the Quality Improvement Core Framework (v7.0.0: STU7 (v7.0.0)) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. 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: 7.0.0
Standards status: Trial-use Maturity Level: 4 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.

"Must Have", "QI Elements" and "primary code path" are defined in the QI-Core Must Support section.
Must Have:
  • lifecycleStatus: proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  • subject: (QI) Who this goal is intended for
  • description: Code or text describing goal
QI Elements:
  • start[x]: (QI) When goal pursuit begins
  • target: (QI) Target outcome for the goal
Primary code path: category
(PCPath) This element is the primary code path for this resource CQL Retrieve

Usage

See the patterns page for implementation and usage patterns.

Examples

Weight Loss Example

Usages:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile 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 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... subject SΣ 1..1 Reference(QICore Patient) (QI) Who this goal is intended for
... start[x] SΣ 0..1 (QI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date S
.... startCodeableConcept CodeableConcept
... target SC 0..* BackboneElement (QI) 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 Reach goal on or before
..... dueDate date S
..... dueDuration Duration

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Goal.lifecycleStatusrequiredGoalLifecycleStatus
http://hl7.org/fhir/ValueSet/goal-status
From the FHIR Standard
Goal.descriptionextensibleUSCoreGoalCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
From the FHIR Standard

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()

This structure is derived from USCoreGoalProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile Describes the intended objective(s) for a patient, group or organization
... subject 1..1 Reference(QICore Patient) (QI) Who this goal is intended for
... start[x] Σ 0..1 (QI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date
.... startCodeableConcept CodeableConcept
... target 0..* BackboneElement (QI) Target outcome for the goal

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
From the FHIR Standard
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile 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
... 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 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ 0..1 CodeableConcept in-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 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 Code or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal
... subject SΣ 1..1 Reference(QICore Patient) (QI) Who this goal is intended for
... start[x] SΣ 0..1 (QI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date S
.... startCodeableConcept CodeableConcept
... target SC 0..* BackboneElement (QI) 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 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 Σ 0..1 Reference(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..* 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Goal.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Goal.lifecycleStatusrequiredGoalLifecycleStatus
http://hl7.org/fhir/ValueSet/goal-status
From the FHIR Standard
Goal.achievementStatuspreferredGoalAchievementStatus
http://hl7.org/fhir/ValueSet/goal-achievement
From the FHIR Standard
Goal.categoryexampleGoalCategory
http://hl7.org/fhir/ValueSet/goal-category
From the FHIR Standard
Goal.prioritypreferredGoalPriority
http://hl7.org/fhir/ValueSet/goal-priority
From the FHIR Standard
Goal.descriptionextensibleUSCoreGoalCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
From the FHIR Standard
Goal.target.measureexampleLOINCCodes(a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
From the FHIR Standard
Goal.target.detail[x]example
Goal.outcomeCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
From the FHIR Standard

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()

This structure is derived from USCoreGoalProfile

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

Maturity: 4

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile 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 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... subject SΣ 1..1 Reference(QICore Patient) (QI) Who this goal is intended for
... start[x] SΣ 0..1 (QI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date S
.... startCodeableConcept CodeableConcept
... target SC 0..* BackboneElement (QI) 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 Reach goal on or before
..... dueDate date S
..... dueDuration Duration

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Goal.lifecycleStatusrequiredGoalLifecycleStatus
http://hl7.org/fhir/ValueSet/goal-status
From the FHIR Standard
Goal.descriptionextensibleUSCoreGoalCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
From the FHIR Standard

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()

Differential View

This structure is derived from USCoreGoalProfile

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile Describes the intended objective(s) for a patient, group or organization
... subject 1..1 Reference(QICore Patient) (QI) Who this goal is intended for
... start[x] Σ 0..1 (QI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date
.... startCodeableConcept CodeableConcept
... target 0..* BackboneElement (QI) Target outcome for the goal

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
From the FHIR Standard

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile 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
... 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 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ 0..1 CodeableConcept in-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 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 Code or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal
... subject SΣ 1..1 Reference(QICore Patient) (QI) Who this goal is intended for
... start[x] SΣ 0..1 (QI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date S
.... startCodeableConcept CodeableConcept
... target SC 0..* BackboneElement (QI) 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 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 Σ 0..1 Reference(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..* 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

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Goal.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
From the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Goal.lifecycleStatusrequiredGoalLifecycleStatus
http://hl7.org/fhir/ValueSet/goal-status
From the FHIR Standard
Goal.achievementStatuspreferredGoalAchievementStatus
http://hl7.org/fhir/ValueSet/goal-achievement
From the FHIR Standard
Goal.categoryexampleGoalCategory
http://hl7.org/fhir/ValueSet/goal-category
From the FHIR Standard
Goal.prioritypreferredGoalPriority
http://hl7.org/fhir/ValueSet/goal-priority
From the FHIR Standard
Goal.descriptionextensibleUSCoreGoalCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
From the FHIR Standard
Goal.target.measureexampleLOINCCodes(a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
From the FHIR Standard
Goal.target.detail[x]example
Goal.outcomeCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
From the FHIR Standard

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()

This structure is derived from USCoreGoalProfile

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

Maturity: 4

 

Other representations of profile: CSV, Excel, Schematron