R4 Draft for Comment
Clinical SummaryThis page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
. Page versions: R5 R4B R4 R3 R2
| Patient Care Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Patient |
StructureDefinition for goal
{
"resourceType": "StructureDefinition",
"id": "Goal",
"meta": {
"lastUpdated": "2017-12-20T15:52:34.818+11:00"
},
"text": {
"status": "generated",
"div": "<div>!-- Snipped for Brevity --></div>"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 2
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "pc"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/Goal",
"name": "Goal",
"status": "draft",
"date": "2017-12-20T15:52:34+11:00",
"publisher": "Health Level Seven International (Patient Care)",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://hl7.org/fhir"
}
]
},
{
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/patientcare/index.cfm"
}
]
}
],
"description": "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.",
"fhirVersion": "3.2.0",
"mapping": [
{
"identity": "v2",
"uri": "http://hl7.org/v2",
"name": "HL7 v2 Mapping"
},
{
"identity": "rim",
"uri": "http://hl7.org/v3",
"name": "RIM Mapping"
},
{
"identity": "w5",
"uri": "http://hl7.org/fhir/w5",
"name": "W5 Mapping"
}
],
"kind": "resource",
"abstract": false,
"type": "Goal",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"derivation": "specialization",
"snapshot": {
"element": [
{
"id": "Goal",
"path": "Goal",
"short": "Describes the intended objective(s) for a patient, group or organization",
"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.",
"comment": "Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.",
"min": 0,
"max": "*",
"constraint": [
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "DomainResource"
},
{
"key": "dom-1",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
"expression": "contained.text.empty()",
"xpath": "not(parent::f:contained and f:text)",
"source": "DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "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",
"expression": "contained.all(('#'+id in %resource.descendants().reference) or descendants().where(reference = '#').exists())",
"xpath": "not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::reference[@value='#'])]))",
"source": "DomainResource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "v2",
"map": "GOL.1"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode<=OBJ]."
},
{
"identity": "w5",
"map": "clinical.careprovision"
}
]
},
{
"id": "Goal.id",
"path": "Goal.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "id"
}
],
"isSummary": true
},
{
"id": "Goal.meta",
"path": "Goal.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"isSummary": true
},
{
"id": "Goal.implicitRules",
"path": "Goal.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"isModifier": true,
"isSummary": true
},
{
"id": "Goal.language",
"path": "Goal.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueReference": {
"reference": "http://hl7.org/fhir/ValueSet/all-languages"
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
}
],
"strength": "extensible",
"description": "A human language.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/languages"
}
}
},
{
"id": "Goal.text",
"path": "Goal.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"condition": [
"dom-1"
],
"mapping": [
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "Goal.contained",
"path": "Goal.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Goal.extension",
"path": "Goal.extension",
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Goal.modifierExtension",
"path": "Goal.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Goal.identifier",
"path": "Goal.identifier",
"short": "External Ids for this goal",
"definition": "This records identifiers associated with this care plan that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).",
"requirements": "Need to allow connection to a wider workflow.",
"min": 0,
"max": "*",
"type": [
{
"code": "Identifier"
}
],
"mapping": [
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".id"
},
{
"identity": "w5",
"map": "id"
}
]
},
{
"id": "Goal.status",
"path": "Goal.status",
"short": "proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected",
"definition": "Indicates whether the goal has been reached and is still considered relevant.",
"comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"requirements": "Allows measuring outcome and whether goal needs to be further tracked.",
"min": 1,
"max": "1",
"type": [
{
"code": "code"
}
],
"isModifier": true,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalStatus"
}
],
"strength": "required",
"description": "Indicates whether the goal has been met and is still being targeted",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/goal-status"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "v2",
"map": "GOL-18-goal life cycle status"
},
{
"identity": "rim",
"map": ".statusCode in-progress = active (classCode = OBJ) achieved = complete sustaining = active (classCode=OBJC) cancelled = aborted"
},
{
"identity": "w5",
"map": "status"
}
]
},
{
"id": "Goal.category",
"path": "Goal.category",
"short": "E.g. Treatment, dietary, behavioral, etc.",
"definition": "Indicates a category the goal falls within.",
"requirements": "Allows goals to be filtered and sorted.",
"min": 0,
"max": "*",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalCategory"
}
],
"strength": "example",
"description": "Codes for grouping and sorting goals",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/goal-category"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "w5",
"map": "class"
}
]
},
{
"id": "Goal.priority",
"path": "Goal.priority",
"short": "high-priority | medium-priority | low-priority",
"definition": "Identifies the mutually agreed level of importance associated with reaching/sustaining the goal.",
"comment": "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)\r\rThe 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\".",
"requirements": "Used for sorting and presenting goals.",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalPriority"
}
],
"strength": "preferred",
"description": "The level of importance associated with a goal",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/goal-priority"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.grade"
},
{
"identity": "rim",
"map": ".priorityCode"
},
{
"identity": "w5",
"map": "grade"
}
]
},
{
"id": "Goal.description",
"path": "Goal.description",
"short": "Code or text describing goal",
"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\".",
"comment": "If no code is available, use CodeableConcept.text.",
"requirements": "Without a description of what's trying to be achieved, element has no purpose.",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalDescription"
}
],
"strength": "example",
"description": "Codes providing the details of a particular goal. This will generally be system or implementation guide-specific. In many systems, only the text element will be used.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "GOL-3.2-goal ID.text"
},
{
"identity": "rim",
"map": ".text"
},
{
"identity": "w5",
"map": "what"
}
]
},
{
"id": "Goal.subject",
"path": "Goal.subject",
"short": "Who this goal is intended for",
"definition": "Identifies the patient, group or organization for whom the goal is being established.",
"requirements": "Subject is optional to support annonymized reporting.",
"min": 1,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
}
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "PID-3-patient ID list"
},
{
"identity": "rim",
"map": ".participation[typeCode=PAT].role[classCode=PAT]"
},
{
"identity": "w5",
"map": "who.focus"
}
]
},
{
"id": "Goal.start[x]",
"path": "Goal.start[x]",
"short": "When goal pursuit begins",
"definition": "The date or event after which the goal should begin being pursued.",
"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.",
"min": 0,
"max": "1",
"type": [
{
"code": "date"
},
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalStartEvent"
}
],
"strength": "example",
"description": "Codes describing events that can trigger the initiation of a goal",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/goal-start-event"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.planned"
},
{
"identity": "w5",
"map": "when.planned"
}
]
},
{
"id": "Goal.target",
"path": "Goal.target",
"short": "Target outcome for the goal",
"definition": "Indicates what should be done by when.",
"requirements": "Allows the progress of the goal to be monitored against an observation or due date.",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
],
"condition": [
"gol-1"
],
"constraint": [
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() | (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "Element"
},
{
"key": "gol-1",
"severity": "error",
"human": "Goal.target.measure is required if Goal.target.detail is populated",
"expression": "(detail.exists() and measure.exists()) or detail.exists().not()",
"xpath": "(exists(f:*[starts-with(local-name(.), 'detail')]) and exists(f:measure)) or not(exists(f:*[starts-with(local-name(.), 'detail')]))"
}
]
},
{
"id": "Goal.target.id",
"path": "Goal.target.id",
"representation": [
"xmlAttr"
],
"short": "xml:id (or equivalent in JSON)",
"definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Goal.target.extension",
"path": "Goal.target.extension",
"short": "Additional Content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "Goal.target.modifierExtension",
"path": "Goal.target.modifierExtension",
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content",
"modifiers"
],
"min": 0,
"max": "*",
"base": {
"path": "BackboneElement.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"isModifier": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "Goal.target.measure",
"path": "Goal.target.measure",
"short": "The parameter whose value is being tracked",
"definition": "The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"gol-1"
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalTargetMeasure"
}
],
"strength": "example",
"description": "Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/observation-codes"
}
}
},
{
"id": "Goal.target.detail[x]",
"path": "Goal.target.detail[x]",
"short": "The target value to be achieved",
"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.",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity"
},
{
"code": "Range"
},
{
"code": "CodeableConcept"
}
],
"condition": [
"gol-1"
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalTargetDetail"
}
],
"strength": "example",
"description": "Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal."
}
},
{
"id": "Goal.target.due[x]",
"path": "Goal.target.due[x]",
"short": "Reach goal on or before",
"definition": "Indicates either the date or the duration after start by which the goal should be met.",
"requirements": "Identifies when the goal should be evaluated.",
"min": 0,
"max": "1",
"type": [
{
"code": "date"
},
{
"code": "Duration"
}
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "w5",
"map": "when.done"
}
]
},
{
"id": "Goal.statusDate",
"path": "Goal.statusDate",
"short": "When goal status took effect",
"definition": "Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc.",
"comment": "To see the date for past statuses, query history.",
"min": 0,
"max": "1",
"type": [
{
"code": "date"
}
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.recorded"
},
{
"identity": "w5",
"map": "when.recorded"
}
]
},
{
"id": "Goal.statusReason",
"path": "Goal.statusReason",
"short": "Reason for current status",
"definition": "Captures the reason for the current status.",
"comment": "This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others.",
"min": 0,
"max": "1",
"type": [
{
"code": "string"
}
]
},
{
"id": "Goal.expressedBy",
"path": "Goal.expressedBy",
"short": "Who's responsible for creating Goal?",
"definition": "Indicates whose goal this is - patient goal, practitioner goal, etc.",
"comment": "This is the individual reponsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.).",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
}
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.source"
},
{
"identity": "w5",
"map": "who.source"
}
]
},
{
"id": "Goal.addresses",
"path": "Goal.addresses",
"short": "Issues addressed by this goal",
"definition": "The identified conditions and other health record elements that are intended to be addressed by the goal.",
"requirements": "Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable.",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationStatement"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/RiskAssessment"
}
],
"mapping": [
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=SUBJ].target[classCode=CONC]"
},
{
"identity": "w5",
"map": "why"
}
]
},
{
"id": "Goal.note",
"path": "Goal.note",
"short": "Comments about the goal",
"definition": "Any comments related to the goal.",
"comment": "May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.",
"requirements": "There's a need to capture information about the goal that doesn't actually describe the goal.",
"min": 0,
"max": "*",
"type": [
{
"code": "Annotation"
}
],
"mapping": [
{
"identity": "v2",
"map": "GOL-16-goal evaluation + NTE?"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
}
]
},
{
"id": "Goal.outcomeCode",
"path": "Goal.outcomeCode",
"short": "What result was achieved regarding the goal?",
"definition": "Identifies the change (or lack of change) at the point when the status of the goal is assessed.",
"comment": "Note that this should not duplicate the goal status.",
"requirements": "Outcome tracking is a key aspect of care planning.",
"min": 0,
"max": "*",
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalOutcome"
}
],
"strength": "example",
"description": "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\"",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
}
}
},
{
"id": "Goal.outcomeReference",
"path": "Goal.outcomeReference",
"short": "Observation that resulted from goal",
"definition": "Details of what's changed (or not changed).",
"comment": "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.",
"requirements": "Outcome tracking is a key aspect of care planning.",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
}
]
}
]
},
"differential": {
"element": [
{
"id": "Goal",
"path": "Goal",
"short": "Describes the intended objective(s) for a patient, group or organization",
"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.",
"comment": "Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.",
"min": 0,
"max": "*",
"mapping": [
{
"identity": "v2",
"map": "GOL.1"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode<=OBJ]."
},
{
"identity": "w5",
"map": "clinical.careprovision"
}
]
},
{
"id": "Goal.identifier",
"path": "Goal.identifier",
"short": "External Ids for this goal",
"definition": "This records identifiers associated with this care plan that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).",
"requirements": "Need to allow connection to a wider workflow.",
"min": 0,
"max": "*",
"type": [
{
"code": "Identifier"
}
],
"mapping": [
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".id"
},
{
"identity": "w5",
"map": "id"
}
]
},
{
"id": "Goal.status",
"path": "Goal.status",
"short": "proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected",
"definition": "Indicates whether the goal has been reached and is still considered relevant.",
"comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
"requirements": "Allows measuring outcome and whether goal needs to be further tracked.",
"min": 1,
"max": "1",
"type": [
{
"code": "code"
}
],
"isModifier": true,
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalStatus"
}
],
"strength": "required",
"description": "Indicates whether the goal has been met and is still being targeted",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/goal-status"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "v2",
"map": "GOL-18-goal life cycle status"
},
{
"identity": "rim",
"map": ".statusCode in-progress = active (classCode = OBJ) achieved = complete sustaining = active (classCode=OBJC) cancelled = aborted"
},
{
"identity": "w5",
"map": "status"
}
]
},
{
"id": "Goal.category",
"path": "Goal.category",
"short": "E.g. Treatment, dietary, behavioral, etc.",
"definition": "Indicates a category the goal falls within.",
"requirements": "Allows goals to be filtered and sorted.",
"min": 0,
"max": "*",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalCategory"
}
],
"strength": "example",
"description": "Codes for grouping and sorting goals",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/goal-category"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.class"
},
{
"identity": "w5",
"map": "class"
}
]
},
{
"id": "Goal.priority",
"path": "Goal.priority",
"short": "high-priority | medium-priority | low-priority",
"definition": "Identifies the mutually agreed level of importance associated with reaching/sustaining the goal.",
"comment": "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)\r\rThe 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\".",
"requirements": "Used for sorting and presenting goals.",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalPriority"
}
],
"strength": "preferred",
"description": "The level of importance associated with a goal",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/goal-priority"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.grade"
},
{
"identity": "rim",
"map": ".priorityCode"
},
{
"identity": "w5",
"map": "grade"
}
]
},
{
"id": "Goal.description",
"path": "Goal.description",
"short": "Code or text describing goal",
"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\".",
"comment": "If no code is available, use CodeableConcept.text.",
"requirements": "Without a description of what's trying to be achieved, element has no purpose.",
"min": 1,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalDescription"
}
],
"strength": "example",
"description": "Codes providing the details of a particular goal. This will generally be system or implementation guide-specific. In many systems, only the text element will be used.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "GOL-3.2-goal ID.text"
},
{
"identity": "rim",
"map": ".text"
},
{
"identity": "w5",
"map": "what"
}
]
},
{
"id": "Goal.subject",
"path": "Goal.subject",
"short": "Who this goal is intended for",
"definition": "Identifies the patient, group or organization for whom the goal is being established.",
"requirements": "Subject is optional to support annonymized reporting.",
"min": 1,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Group"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Organization"
}
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "PID-3-patient ID list"
},
{
"identity": "rim",
"map": ".participation[typeCode=PAT].role[classCode=PAT]"
},
{
"identity": "w5",
"map": "who.focus"
}
]
},
{
"id": "Goal.start[x]",
"path": "Goal.start[x]",
"short": "When goal pursuit begins",
"definition": "The date or event after which the goal should begin being pursued.",
"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.",
"min": 0,
"max": "1",
"type": [
{
"code": "date"
},
{
"code": "CodeableConcept"
}
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalStartEvent"
}
],
"strength": "example",
"description": "Codes describing events that can trigger the initiation of a goal",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/goal-start-event"
}
},
"mapping": [
{
"identity": "w5",
"map": "FiveWs.planned"
},
{
"identity": "w5",
"map": "when.planned"
}
]
},
{
"id": "Goal.target",
"path": "Goal.target",
"short": "Target outcome for the goal",
"definition": "Indicates what should be done by when.",
"requirements": "Allows the progress of the goal to be monitored against an observation or due date.",
"min": 0,
"max": "1",
"type": [
{
"code": "BackboneElement"
}
],
"condition": [
"gol-1"
],
"constraint": [
{
"key": "gol-1",
"severity": "error",
"human": "Goal.target.measure is required if Goal.target.detail is populated",
"expression": "(detail.exists() and measure.exists()) or detail.exists().not()",
"xpath": "(exists(f:*[starts-with(local-name(.), 'detail')]) and exists(f:measure)) or not(exists(f:*[starts-with(local-name(.), 'detail')]))"
}
]
},
{
"id": "Goal.target.measure",
"path": "Goal.target.measure",
"short": "The parameter whose value is being tracked",
"definition": "The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.",
"min": 0,
"max": "1",
"type": [
{
"code": "CodeableConcept"
}
],
"condition": [
"gol-1"
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalTargetMeasure"
}
],
"strength": "example",
"description": "Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/observation-codes"
}
}
},
{
"id": "Goal.target.detail[x]",
"path": "Goal.target.detail[x]",
"short": "The target value to be achieved",
"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.",
"min": 0,
"max": "1",
"type": [
{
"code": "Quantity"
},
{
"code": "Range"
},
{
"code": "CodeableConcept"
}
],
"condition": [
"gol-1"
],
"isSummary": true,
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalTargetDetail"
}
],
"strength": "example",
"description": "Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal."
}
},
{
"id": "Goal.target.due[x]",
"path": "Goal.target.due[x]",
"short": "Reach goal on or before",
"definition": "Indicates either the date or the duration after start by which the goal should be met.",
"requirements": "Identifies when the goal should be evaluated.",
"min": 0,
"max": "1",
"type": [
{
"code": "date"
},
{
"code": "Duration"
}
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.done[x]"
},
{
"identity": "w5",
"map": "when.done"
}
]
},
{
"id": "Goal.statusDate",
"path": "Goal.statusDate",
"short": "When goal status took effect",
"definition": "Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc.",
"comment": "To see the date for past statuses, query history.",
"min": 0,
"max": "1",
"type": [
{
"code": "date"
}
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.recorded"
},
{
"identity": "w5",
"map": "when.recorded"
}
]
},
{
"id": "Goal.statusReason",
"path": "Goal.statusReason",
"short": "Reason for current status",
"definition": "Captures the reason for the current status.",
"comment": "This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others.",
"min": 0,
"max": "1",
"type": [
{
"code": "string"
}
]
},
{
"id": "Goal.expressedBy",
"path": "Goal.expressedBy",
"short": "Who's responsible for creating Goal?",
"definition": "Indicates whose goal this is - patient goal, practitioner goal, etc.",
"comment": "This is the individual reponsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.).",
"min": 0,
"max": "1",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Patient"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/RelatedPerson"
}
],
"isSummary": true,
"mapping": [
{
"identity": "w5",
"map": "FiveWs.source"
},
{
"identity": "w5",
"map": "who.source"
}
]
},
{
"id": "Goal.addresses",
"path": "Goal.addresses",
"short": "Issues addressed by this goal",
"definition": "The identified conditions and other health record elements that are intended to be addressed by the goal.",
"requirements": "Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable.",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/MedicationStatement"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/NutritionOrder"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
},
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/RiskAssessment"
}
],
"mapping": [
{
"identity": "w5",
"map": "FiveWs.why[x]"
},
{
"identity": "rim",
"map": ".outboundRelationship[typeCode=SUBJ].target[classCode=CONC]"
},
{
"identity": "w5",
"map": "why"
}
]
},
{
"id": "Goal.note",
"path": "Goal.note",
"short": "Comments about the goal",
"definition": "Any comments related to the goal.",
"comment": "May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.",
"requirements": "There's a need to capture information about the goal that doesn't actually describe the goal.",
"min": 0,
"max": "*",
"type": [
{
"code": "Annotation"
}
],
"mapping": [
{
"identity": "v2",
"map": "GOL-16-goal evaluation + NTE?"
},
{
"identity": "rim",
"map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value"
}
]
},
{
"id": "Goal.outcomeCode",
"path": "Goal.outcomeCode",
"short": "What result was achieved regarding the goal?",
"definition": "Identifies the change (or lack of change) at the point when the status of the goal is assessed.",
"comment": "Note that this should not duplicate the goal status.",
"requirements": "Outcome tracking is a key aspect of care planning.",
"min": 0,
"max": "*",
"type": [
{
"code": "CodeableConcept"
}
],
"binding": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "GoalOutcome"
}
],
"strength": "example",
"description": "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\"",
"valueSetReference": {
"reference": "http://hl7.org/fhir/ValueSet/clinical-findings"
}
}
},
{
"id": "Goal.outcomeReference",
"path": "Goal.outcomeReference",
"short": "Observation that resulted from goal",
"definition": "Details of what's changed (or not changed).",
"comment": "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.",
"requirements": "Outcome tracking is a key aspect of care planning.",
"min": 0,
"max": "*",
"type": [
{
"code": "Reference",
"targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation"
}
]
}
]
}
}
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
®© HL7.org 2011+. FHIR Release 4 Draft for Comment (Jan-2018 v3.2.0-12885) generated on Wed, Dec 20, 2017 15:57+1100. QA Page
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