~~Release 4~~ FHIR CI-Build

This ~~page~~ is ~~part of~~ the Continuous Integration Build of FHIR ~~Specification (v4.0.1: R4 - Mixed Normative and STU ) in it's permanent home (it will always~~ (will be ~~available~~ incorrect/inconsistent at ~~this URL). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see~~ times).
See the Directory of published versions icon ~~. Page versions: R5 R4B R4 R3 R2~~

9.6 Resource Goal - Content

Responsible Owner: Patient Care icon

Work Group

~~Maturity Level : 2~~ Trial Use

Security Category : Patient

Compartments : Group , Patient

Describes the intended objective(s) for a patient, ~~group~~ group, or ~~organization care, for example,~~ organizational care. Examples include a patient's weight loss, ~~restoring~~ restoration of an activity of daily ~~living,~~ living for a patient, obtaining herd immunity via ~~immunization,~~ immunization for a group, meeting a process improvement ~~objective,~~ objective for an organization, etc.

9.6.1 Scope and Usage

A Goal in health care services delivery is generally an expressed desired health state to be achieved by a subject of care (or family/group) over a period or at a specific point of time. This desired target health state may be achieved as a result of health care intervention(s) or resulting from natural recovery over time. For example:

A goal of a plan for a condition such as a diabetes might specify desired outcome(s) (e.g. HgbA1c level =<5.6% in 3 months) as a result of interventions such as medication therapy, nutritional management and/or ~~increase~~ increased physical activity.
A goal of a procedure might be to meet the intended objective of the procedure (e.g. wet-dry-dressing changes twice a day; goal: wound healed completely in 2 weeks) or to prevent an unintended complication (e.g. repositioning a patient every two hours: goal to maintain skin integrity)

Goals may address the prevention of illness, cure or mitigation of a condition, prolongation of life, or mitigation of pain and discomfort.

When dealing with groups, goals may also reflect health state, such as a reduction of addiction behaviors. However, they may also reflect population health objectives such as education, screening, etc.

Organizational goals are typically not health state specific but may instead identify measurement targets such as infection control, cost management, patient satisfaction, etc.

9.6.2 Boundaries and Relationships

Goals are typically established in the context of a CarePlan . However, goals may also be directly referenced by request-type resources (e.g. MedicationRequest or ServiceRequest ) by using an extension.

A goal represents a specific goal instance for a particular patient, group, etc. It is not intended to be used to define types of potential goals as part of an order set or protocol definition. Protocol definitions and order sets are supported through PlanDefinition . The Goal resource is intended to be used once an order set is instantiated or assigned to a patient, which is when the potential goals become the actual goals, if not changed or deleted.

Goals are often evaluated using Observations .

~~This~~ Goal does not include the legal Advance Directives, which should be represented with the Consent resource ~~is referenced by~~ with Consent.category = Advance Directive or a request resource with the intent = directive. Legal Advance Directives may specify clinical goals that can be represented as a Goal resource as well. Informally, advance directives could be represented as a Goal resource regardless of whether it was included in the legal Consent, such as "I want to die at home."

9.6.3 References to this Resource

Resource References: CarePlan and RequestOrchestration
Extension References: Conditions , Dosage - Minimum Gap Between Doses , Goal: Related Goal and Resource Pertains To Goal

Structure

~~CodeableConcept~~ 0..* ~~0..1~~ ~~outcomeReference 0..* Reference ( Observation ) Observation that resulted from goal~~

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Goal	TU		DomainResource	Describes the intended objective(s) for a patient, ~~group~~ group, or ~~organization~~ organizational care Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
identifier		0..*	Identifier	External Ids for this goal
lifecycleStatus	?! Σ	1..1	code	proposed \| planned \| accepted \| active \| on-hold \| completed \| cancelled \| entered-in-error \| rejected ~~GoalLifecycleStatus~~ Binding: Goal Lifecycle Status ( Required )
achievementStatus	Σ	0..1	CodeableConcept	in-progress \| improving \| worsening \| no-change \| achieved \| sustaining \| not-achieved \| no-progress \| not-attainable Binding: Goal ~~achievement status~~ Achievement Status ( Preferred )
category	Σ	0..*	CodeableConcept	E.g. Treatment, dietary, behavioral, ~~etc.~~ etc Binding: Goal ~~category~~ Category ( Example )
~~priority~~ continuous		0..1	Σ boolean	After meeting the goal, ongoing activity is needed to sustain the goal objective ~~0..1~~
priority	Σ	0..1	CodeableConcept	high-priority \| medium-priority \| low-priority Binding: Goal ~~priority~~ Priority ( Preferred )
description	Σ	1..1	CodeableConcept	Code or text describing goal ~~SNOMED CT Clinical Findings~~ Binding: Goal Description ( Example )
subject	Σ	1..1	Reference ( Patient \| Group \| Organization )	Who this goal is intended for
start[x]	Σ	0..1		When goal pursuit begins Binding: Goal ~~start event~~ Start Event ( Example )
startDate			date
startCodeableConcept			CodeableConcept
acceptance		0..*	BackboneElement	Individual acceptance of goal
~~target~~ participant		1..1	I Reference ( Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| CareTeam \| Organization \| Group )	Individual or organization whose acceptance is reflected
status		0..1	~~BackboneElement~~ code	agree \| disagree \| pending Binding: Goal acceptance status value set ( Required )
priority		0..1	CodeableConcept	Priority of goal for individual Binding: Goal Priority ( Example )
target	C	0..*	BackboneElement	Target outcome for the goal + Rule: Goal.target.measure is required if Goal.target.detail is populated
measure	Σ I C	0..1	CodeableConcept	The parameter whose value is being tracked Binding: LOINC Codes ( Example )
detail[x]	Σ I C	0..1		The target value to be achieved
detailQuantity			Quantity
detailRange			Range
detailCodeableConcept			CodeableConcept
detailString			string
detailBoolean			boolean
detailInteger			integer
detailRatio			Ratio
due[x]	Σ	0..1		Reach goal on or before
dueDate			date
dueDuration			Duration
statusDate	Σ	0..1	date	When goal achievment status took effect
statusReason		0..*	~~string~~ CodeableConcept	Reason for current lifecycle status Binding: Goal Status Reason ( Example )
~~expressedBy~~ recorder	Σ	0..1	Reference ( Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Group )	Who recorded the goal
source	Σ	0..1	Reference ( Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| CareTeam \| Group )	Who's responsible for creating Goal?
addresses		0..*	Reference ( Condition \| Observation \| MedicationStatement \| MedicationRequest \| NutritionOrder \| ServiceRequest \| RiskAssessment \| Procedure \| NutritionIntake )	Issues addressed by this goal
note		0..*	Annotation	Comments about the goal ~~outcomeCode 0..* CodeableConcept What result was achieved regarding the goal? SNOMED CT Clinical Findings ( Example )~~
Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

XML Template

<

<Goal xmlns="http://hl7.org/fhir"> 

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this goal --></identifier>
 <lifecycleStatus value="[code]"/><!-- 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected -->
 <achievementStatus><!-- 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable --></achievementStatus>
 <</category>

 <category><!-- 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc --></category>
 <continuous value="[boolean]"/><!-- 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective -->

 <priority><!-- 0..1 CodeableConcept high-priority | medium-priority | low-priority --></priority>
 <</description>
 <</subject>

 <description><!-- 1..1 CodeableConcept Code or text describing goal --></description>
 <subject><!-- 1..1 Reference(Group|Organization|Patient) Who this goal is intended for --></subject>

 <start[x]><!-- 0..1 date|CodeableConcept When goal pursuit begins --></start[x]>
 <
  <</measure>
  <|

 <acceptance>  <!-- 0..* Individual acceptance of goal -->
  <participant><!-- 1..1 Reference(CareTeam|Group|Organization|Patient|
    Practitioner|PractitionerRole|RelatedPerson) Individual or organization whose acceptance is reflected --></participant>

  <status value="[code]"/><!-- 0..1 agree | disagree | pending -->
  <priority><!-- 0..1 CodeableConcept Priority of goal for individual --></priority>
 </acceptance>
 <target>  <!-- 0..* Target outcome for the goal -->
  <measure><!-- I 0..1 CodeableConcept The parameter whose value is being tracked --></measure>
  <detail[x]><!-- I 0..1 Quantity|Range|CodeableConcept|string|boolean|integer|

    Ratio The target value to be achieved --></detail[x]>
  <due[x]><!-- 0..1 date|Duration Reach goal on or before --></due[x]>
 </target>
 <
 <
 <|
   </expressedBy>
 <|
   </addresses>

 <statusDate value="[date]"/><!-- 0..1 When goal achievment status took effect -->
 <statusReason><!-- 0..* CodeableConcept Reason for current lifecycle status --></statusReason>
 <recorder><!-- 0..1 Reference(Group|Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who recorded the goal --></recorder>

 <source><!-- 0..1 Reference(CareTeam|Group|Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who's responsible for creating Goal? --></source>

 <addresses><!-- 0..* Reference(Condition|MedicationRequest|MedicationStatement|
   NutritionIntake|NutritionOrder|Observation|Procedure|RiskAssessment|
   ServiceRequest) Issues addressed by this goal --></addresses>
 <note><!-- 0..* Annotation Comments about the goal --></note>
 <</outcomeCode>
 <</outcomeReference>

</Goal>

JSON Template

{
  "resourceType" : "",

  "resourceType" : "Goal",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Ids for this goal
  "lifecycleStatus" : "<code>", // R!  proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  "achievementStatus" : { CodeableConcept }, // in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
  "

  "category" : [{ CodeableConcept }], // E.g. Treatment, dietary, behavioral, etc
  "continuous" : <boolean>, // After meeting the goal, ongoing activity is needed to sustain the goal objective

  "priority" : { CodeableConcept }, // high-priority | medium-priority | low-priority
  "
  "

  "description" : { CodeableConcept }, // R!  Code or text describing goal
  "subject" : { Reference(Group|Organization|Patient) }, // R!  Who this goal is intended for

  // start[x]: When goal pursuit begins. One of these 2:
  "startDate" : "<date>",
  "startCodeableConcept" : { CodeableConcept },
  "
    "

  "acceptance" : [{ // Individual acceptance of goal
    "participant" : { Reference(CareTeam|Group|Organization|Patient|
    Practitioner|PractitionerRole|RelatedPerson) }, // R!  Individual or organization whose acceptance is reflected

    "status" : "<code>", // agree | disagree | pending
    "priority" : { CodeableConcept } // Priority of goal for individual
  }],
  "target" : [{ // Target outcome for the goal
    "measure" : { CodeableConcept }, // I The parameter whose value is being tracked

    // detail[x]: The target value to be achieved. One of these 7:
    " },
    " },
    " },
    ">",
    ">,
    ">,
    " },

    "detailQuantity" : { Quantity },
    "detailRange" : { Range },
    "detailCodeableConcept" : { CodeableConcept },
    "detailString" : "<string>",
    "detailBoolean" : <boolean>,
    "detailInteger" : <integer>,
    "detailRatio" : { Ratio },

    // due[x]: Reach goal on or before. One of these 2:
    ">"

    "dueDate" : "<date>",

    "dueDuration" : { Duration }
  }],
  "
  "
  "|

  "statusDate" : "<date>", // When goal achievment status took effect
  "statusReason" : [{ CodeableConcept }], // Reason for current lifecycle status
  "recorder" : { Reference(Group|Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who recorded the goal

  "source" : { Reference(CareTeam|Group|Patient|Practitioner|PractitionerRole|

   RelatedPerson) }, // Who's responsible for creating Goal?
  "|
   
  "
  "
  "

  "addresses" : [{ Reference(Condition|MedicationRequest|MedicationStatement|
   NutritionIntake|NutritionOrder|Observation|Procedure|RiskAssessment|
   ServiceRequest) }], // Issues addressed by this goal

  "note" : [{ Annotation }] // Comments about the goal

}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:;

[ a fhir:Goal;

  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  # . One of these 2
    fhir: ]
    fhir: ]
  fhir:
    fhir:
    # . One of these 7
      fhir: ]
      fhir: ]
      fhir: ]
      fhir: ]
      fhir: ]
      fhir: ]
      fhir: ]
    # . One of these 2
      fhir: ]
      fhir: ]
  ], ...;
  fhir:
  fhir:
  fhir:
  fhir:|
  
  fhir:
  fhir:
  fhir:

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External Ids for this goal
  fhir:lifecycleStatus [ code ] ; # 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  fhir:achievementStatus [ CodeableConcept ] ; # 0..1 in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* E.g. Treatment, dietary, behavioral, etc
  fhir:continuous [ boolean ] ; # 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective
  fhir:priority [ CodeableConcept ] ; # 0..1 high-priority | medium-priority | low-priority
  fhir:description [ CodeableConcept ] ; # 1..1 Code or text describing goal
  fhir:subject [ Reference(Group|Organization|Patient) ] ; # 1..1 Who this goal is intended for
  # start[x] : 0..1 When goal pursuit begins. One of these 2
    fhir:start [  a fhir:Date ; date ]
    fhir:start [  a fhir:CodeableConcept ; CodeableConcept ]
  fhir:acceptance ( [ # 0..* Individual acceptance of goal
    fhir:participant [ Reference(CareTeam|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 1..1 Individual or organization whose acceptance is reflected
    fhir:status [ code ] ; # 0..1 agree | disagree | pending
    fhir:priority [ CodeableConcept ] ; # 0..1 Priority of goal for individual
  ] ... ) ;
  fhir:target ( [ # 0..* Target outcome for the goal
    fhir:measure [ CodeableConcept ] ; # 0..1 I The parameter whose value is being tracked
    # detail[x] : 0..1 I The target value to be achieved. One of these 7
      fhir:detail [  a fhir:Quantity ; Quantity ]
      fhir:detail [  a fhir:Range ; Range ]
      fhir:detail [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:detail [  a fhir:String ; string ]
      fhir:detail [  a fhir:Boolean ; boolean ]
      fhir:detail [  a fhir:Integer ; integer ]
      fhir:detail [  a fhir:Ratio ; Ratio ]
    # due[x] : 0..1 Reach goal on or before. One of these 2
      fhir:due [  a fhir:Date ; date ]
      fhir:due [  a fhir:Duration ; Duration ]
  ] ... ) ;
  fhir:statusDate [ date ] ; # 0..1 When goal achievment status took effect
  fhir:statusReason  ( [ CodeableConcept ] ... ) ; # 0..* Reason for current lifecycle status
  fhir:recorder [ Reference(Group|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who recorded the goal
  fhir:source [ Reference(CareTeam|Group|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who's responsible for creating Goal?
  fhir:addresses  ( [ Reference(Condition|MedicationRequest|MedicationStatement|NutritionIntake|NutritionOrder|
  Observation|Procedure|RiskAssessment|ServiceRequest) ] ... ) ; # 0..* Issues addressed by this goal

  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments about the goal

]

Changes ~~since R3~~ from both R4 and R4B

Goal

Goal.lifecycleStatus

Remove codes active,on-hold,completed

Goal.continuous

Added Element

Goal.acceptance

Added Element

Goal.acceptance.participant

Added Mandatory Element

~~Goal.achievementStatus~~ Goal.acceptance.status

Added Element

~~Goal.subject~~ Goal.acceptance.priority

~~Min Cardinality changed from 0 to 1~~ Added Element

~~Goal.target~~ Goal.statusReason

Max Cardinality changed from 1 to *
Type changed from string to CodeableConcept

~~Goal.target.detail[x]~~ Goal.recorder

~~Add Types string, boolean, integer, Ratio~~ Added Element

~~Goal.expressedBy~~ Goal.source

Renamed from expressedBy to source
Type Reference: Added Target ~~Type PractitionerRole~~ Types CareTeam, Group

Goal.addresses

Type Reference: Added Target ~~Type ServiceRequest~~ Types MedicationRequest, Procedure, NutritionIntake

Goal.outcomeCode

~~Type Reference: Removed Target Type ProcedureRequest~~ Deleted (-> Goal.outcome)

~~Goal.status~~ Goal.outcomeReference

~~deleted~~ Deleted (-> Goal.outcome)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON ~~. See R3 <--> R4 Conversion Maps~~ ~~(status = 2 tests that all execute ok. All tests pass round-trip testing~~ and ~~all r3 resources are valid.)~~ for R4B as XML or JSON .

Structure

~~CodeableConcept~~ 0..* ~~0..1~~

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Goal	TU		DomainResource	Describes the intended objective(s) for a patient, ~~group~~ group, or ~~organization~~ organizational care Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
identifier		0..*	Identifier	External Ids for this goal
lifecycleStatus	?! Σ	1..1	code	proposed \| planned \| accepted \| active \| on-hold \| completed \| cancelled \| entered-in-error \| rejected ~~GoalLifecycleStatus~~ Binding: Goal Lifecycle Status ( Required )
achievementStatus	Σ	0..1	CodeableConcept	in-progress \| improving \| worsening \| no-change \| achieved \| sustaining \| not-achieved \| no-progress \| not-attainable Binding: Goal ~~achievement status~~ Achievement Status ( Preferred )
category	Σ	0..*	CodeableConcept	E.g. Treatment, dietary, behavioral, ~~etc.~~ etc Binding: Goal ~~category~~ Category ( Example )
~~priority~~ continuous		0..1	Σ boolean	After meeting the goal, ongoing activity is needed to sustain the goal objective
priority	Σ	0..1	CodeableConcept	high-priority \| medium-priority \| low-priority Binding: Goal ~~priority~~ Priority ( Preferred )
description	Σ	1..1	CodeableConcept	Code or text describing goal ~~SNOMED CT Clinical Findings~~ Binding: Goal Description ( Example )
subject	Σ	1..1	Reference ( Patient \| Group \| Organization )	Who this goal is intended for
start[x]	Σ	0..1		When goal pursuit begins Binding: Goal ~~start event~~ Start Event ( Example )
startDate			date
startCodeableConcept			CodeableConcept
acceptance		0..*	BackboneElement	Individual acceptance of goal
~~target~~ participant		1..1	I Reference ( Patient \| Practitioner \| RelatedPerson \| PractitionerRole \| CareTeam \| Organization \| Group )	Individual or organization whose acceptance is reflected
status		0..1	code ~~BackboneElement~~	agree \| disagree \| pending Binding: Goal acceptance status value set ( Required )
priority		0..1	CodeableConcept	Priority of goal for individual Binding: Goal Priority ( Example )
target	C	0..*	BackboneElement	Target outcome for the goal + Rule: Goal.target.measure is required if Goal.target.detail is populated
measure	Σ I C	0..1	CodeableConcept	The parameter whose value is being tracked Binding: LOINC Codes ( Example )
detail[x]	Σ I C	0..1		The target value to be achieved
detailQuantity			Quantity
detailRange			Range
detailCodeableConcept			CodeableConcept
detailString			string
detailBoolean			boolean
detailInteger			integer
detailRatio			Ratio
due[x]	Σ	0..1		Reach goal on or before
dueDate			date
dueDuration			Duration
statusDate	Σ	0..1	date	When goal achievment status took effect
statusReason		0..*	~~string~~ CodeableConcept	Reason for current lifecycle status Binding: Goal Status Reason ( Example )
~~expressedBy~~ recorder	Σ	0..1	Reference ( Practitioner \| PractitionerRole \| Patient \| RelatedPerson \| Group )	Who recorded the goal
source	Σ	0..1	Reference ( Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| CareTeam \| Group )	Who's responsible for creating Goal?
addresses		0..*	Reference ( Condition \| Observation \| MedicationStatement \| MedicationRequest \| NutritionOrder \| ServiceRequest \| RiskAssessment \| Procedure \| NutritionIntake )	Issues addressed by this goal
note		0..*	Annotation	Comments about the goal outcomeCode 0..* CodeableConcept What result was achieved regarding the goal? SNOMED CT Clinical Findings ( Example ) outcomeReference 0..* Reference ( Observation ) Observation that resulted from goal
Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

XML Template

<

<Goal xmlns="http://hl7.org/fhir"> 

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this goal --></identifier>
 <lifecycleStatus value="[code]"/><!-- 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected -->
 <achievementStatus><!-- 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable --></achievementStatus>
 <</category>

 <category><!-- 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc --></category>
 <continuous value="[boolean]"/><!-- 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective -->

 <priority><!-- 0..1 CodeableConcept high-priority | medium-priority | low-priority --></priority>
 <</description>
 <</subject>

 <description><!-- 1..1 CodeableConcept Code or text describing goal --></description>
 <subject><!-- 1..1 Reference(Group|Organization|Patient) Who this goal is intended for --></subject>

 <start[x]><!-- 0..1 date|CodeableConcept When goal pursuit begins --></start[x]>
 <
  <</measure>
  <|

 <acceptance>  <!-- 0..* Individual acceptance of goal -->
  <participant><!-- 1..1 Reference(CareTeam|Group|Organization|Patient|
    Practitioner|PractitionerRole|RelatedPerson) Individual or organization whose acceptance is reflected --></participant>

  <status value="[code]"/><!-- 0..1 agree | disagree | pending -->
  <priority><!-- 0..1 CodeableConcept Priority of goal for individual --></priority>
 </acceptance>
 <target>  <!-- 0..* Target outcome for the goal -->
  <measure><!-- I 0..1 CodeableConcept The parameter whose value is being tracked --></measure>
  <detail[x]><!-- I 0..1 Quantity|Range|CodeableConcept|string|boolean|integer|

    Ratio The target value to be achieved --></detail[x]>
  <due[x]><!-- 0..1 date|Duration Reach goal on or before --></due[x]>
 </target>
 <
 <
 <|
   </expressedBy>
 <|
   </addresses>

 <statusDate value="[date]"/><!-- 0..1 When goal achievment status took effect -->
 <statusReason><!-- 0..* CodeableConcept Reason for current lifecycle status --></statusReason>
 <recorder><!-- 0..1 Reference(Group|Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who recorded the goal --></recorder>

 <source><!-- 0..1 Reference(CareTeam|Group|Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who's responsible for creating Goal? --></source>

 <addresses><!-- 0..* Reference(Condition|MedicationRequest|MedicationStatement|
   NutritionIntake|NutritionOrder|Observation|Procedure|RiskAssessment|
   ServiceRequest) Issues addressed by this goal --></addresses>
 <note><!-- 0..* Annotation Comments about the goal --></note>
 <</outcomeCode>
 <</outcomeReference>

</Goal>

JSON Template

{
  "resourceType" : "",

  "resourceType" : "Goal",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Ids for this goal
  "lifecycleStatus" : "<code>", // R!  proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  "achievementStatus" : { CodeableConcept }, // in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
  "

  "category" : [{ CodeableConcept }], // E.g. Treatment, dietary, behavioral, etc
  "continuous" : <boolean>, // After meeting the goal, ongoing activity is needed to sustain the goal objective

  "priority" : { CodeableConcept }, // high-priority | medium-priority | low-priority
  "
  "

  "description" : { CodeableConcept }, // R!  Code or text describing goal
  "subject" : { Reference(Group|Organization|Patient) }, // R!  Who this goal is intended for

  // start[x]: When goal pursuit begins. One of these 2:
  "startDate" : "<date>",
  "startCodeableConcept" : { CodeableConcept },
  "
    "

  "acceptance" : [{ // Individual acceptance of goal
    "participant" : { Reference(CareTeam|Group|Organization|Patient|
    Practitioner|PractitionerRole|RelatedPerson) }, // R!  Individual or organization whose acceptance is reflected

    "status" : "<code>", // agree | disagree | pending
    "priority" : { CodeableConcept } // Priority of goal for individual
  }],
  "target" : [{ // Target outcome for the goal
    "measure" : { CodeableConcept }, // I The parameter whose value is being tracked

    // detail[x]: The target value to be achieved. One of these 7:
    " },
    " },
    " },
    ">",
    ">,
    ">,
    " },

    "detailQuantity" : { Quantity },
    "detailRange" : { Range },
    "detailCodeableConcept" : { CodeableConcept },
    "detailString" : "<string>",
    "detailBoolean" : <boolean>,
    "detailInteger" : <integer>,
    "detailRatio" : { Ratio },

    // due[x]: Reach goal on or before. One of these 2:
    ">"

    "dueDate" : "<date>",

    "dueDuration" : { Duration }
  }],
  "
  "
  "|

  "statusDate" : "<date>", // When goal achievment status took effect
  "statusReason" : [{ CodeableConcept }], // Reason for current lifecycle status
  "recorder" : { Reference(Group|Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who recorded the goal

  "source" : { Reference(CareTeam|Group|Patient|Practitioner|PractitionerRole|

   RelatedPerson) }, // Who's responsible for creating Goal?
  "|
   
  "
  "
  "

  "addresses" : [{ Reference(Condition|MedicationRequest|MedicationStatement|
   NutritionIntake|NutritionOrder|Observation|Procedure|RiskAssessment|
   ServiceRequest) }], // Issues addressed by this goal

  "note" : [{ Annotation }] // Comments about the goal

}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:;

[ a fhir:Goal;

  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  # . One of these 2
    fhir: ]
    fhir: ]
  fhir:
    fhir:
    # . One of these 7
      fhir: ]
      fhir: ]
      fhir: ]
      fhir: ]
      fhir: ]
      fhir: ]
      fhir: ]
    # . One of these 2
      fhir: ]
      fhir: ]
  ], ...;
  fhir:
  fhir:
  fhir:
  fhir:|
  
  fhir:
  fhir:
  fhir:

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* External Ids for this goal
  fhir:lifecycleStatus [ code ] ; # 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  fhir:achievementStatus [ CodeableConcept ] ; # 0..1 in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* E.g. Treatment, dietary, behavioral, etc
  fhir:continuous [ boolean ] ; # 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective
  fhir:priority [ CodeableConcept ] ; # 0..1 high-priority | medium-priority | low-priority
  fhir:description [ CodeableConcept ] ; # 1..1 Code or text describing goal
  fhir:subject [ Reference(Group|Organization|Patient) ] ; # 1..1 Who this goal is intended for
  # start[x] : 0..1 When goal pursuit begins. One of these 2
    fhir:start [  a fhir:Date ; date ]
    fhir:start [  a fhir:CodeableConcept ; CodeableConcept ]
  fhir:acceptance ( [ # 0..* Individual acceptance of goal
    fhir:participant [ Reference(CareTeam|Group|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 1..1 Individual or organization whose acceptance is reflected
    fhir:status [ code ] ; # 0..1 agree | disagree | pending
    fhir:priority [ CodeableConcept ] ; # 0..1 Priority of goal for individual
  ] ... ) ;
  fhir:target ( [ # 0..* Target outcome for the goal
    fhir:measure [ CodeableConcept ] ; # 0..1 I The parameter whose value is being tracked
    # detail[x] : 0..1 I The target value to be achieved. One of these 7
      fhir:detail [  a fhir:Quantity ; Quantity ]
      fhir:detail [  a fhir:Range ; Range ]
      fhir:detail [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:detail [  a fhir:String ; string ]
      fhir:detail [  a fhir:Boolean ; boolean ]
      fhir:detail [  a fhir:Integer ; integer ]
      fhir:detail [  a fhir:Ratio ; Ratio ]
    # due[x] : 0..1 Reach goal on or before. One of these 2
      fhir:due [  a fhir:Date ; date ]
      fhir:due [  a fhir:Duration ; Duration ]
  ] ... ) ;
  fhir:statusDate [ date ] ; # 0..1 When goal achievment status took effect
  fhir:statusReason  ( [ CodeableConcept ] ... ) ; # 0..* Reason for current lifecycle status
  fhir:recorder [ Reference(Group|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who recorded the goal
  fhir:source [ Reference(CareTeam|Group|Patient|Practitioner|PractitionerRole|RelatedPerson) ] ; # 0..1 Who's responsible for creating Goal?
  fhir:addresses  ( [ Reference(Condition|MedicationRequest|MedicationStatement|NutritionIntake|NutritionOrder|
  Observation|Procedure|RiskAssessment|ServiceRequest) ] ... ) ; # 0..* Issues addressed by this goal

  fhir:note  ( [ Annotation ] ... ) ; # 0..* Comments about the goal

]

Changes ~~since Release 3~~ from both R4 and R4B

Goal

Goal.lifecycleStatus

Remove codes active,on-hold,completed

Goal.continuous

Added Element

Goal.acceptance

Added Element

Goal.acceptance.participant

Added Mandatory Element

~~Goal.achievementStatus~~ Goal.acceptance.status

Added Element

~~Goal.subject~~ Goal.acceptance.priority

~~Min Cardinality changed from 0 to 1~~ Added Element

~~Goal.target~~ Goal.statusReason

Max Cardinality changed from 1 to *
Type changed from string to CodeableConcept

~~Goal.target.detail[x]~~ Goal.recorder

~~Add Types string, boolean, integer, Ratio~~ Added Element

~~Goal.expressedBy~~ Goal.source

Renamed from expressedBy to source
Type Reference: Added Target ~~Type PractitionerRole~~ Types CareTeam, Group

Goal.addresses

Type Reference: Added Target ~~Type ServiceRequest~~ Types MedicationRequest, Procedure, NutritionIntake

Goal.outcomeCode

~~Type Reference: Removed Target Type ProcedureRequest~~ Deleted (-> Goal.outcome)

~~Goal.status~~ Goal.outcomeReference

~~deleted~~ Deleted (-> Goal.outcome)

See the Full Difference for further information

This analysis is available for R4 as XML or JSON ~~. See R3 <--> R4 Conversion Maps~~ ~~(status = 2 tests that all execute ok. All tests pass round-trip testing~~ and ~~all r3 resources are valid.)~~ for R4B as XML or JSON .

~~See the Profiles & Extensions and the alternate~~ Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis

9.6.3.1 9.6.4.1 Terminology Bindings

~~Required~~ ~~Example~~ ~~Goal.target.detail[x]~~ ~~Goal.outcomeCode~~

Path	~~Definition~~ ValueSet	Type	~~Reference~~ Documentation
Goal.lifecycleStatus	GoalLifecycleStatus	Required	Codes that reflect the current state of a goal and whether the goal is still being targeted.
Goal.achievementStatus	~~GoalLifecycleStatus~~ GoalAchievementStatus	~~Goal.achievementStatus~~ Preferred	~~Indicates~~ Describes the progression, or lack thereof, towards the goal against the target. ~~Preferred GoalAchievementStatus~~
Goal.category	~~Codes for grouping and sorting goals.~~ GoalCategory	Example	~~GoalCategory~~ Example codes for grouping goals to use for filtering or presentation.
Goal.priority	~~The level of importance associated with a goal.~~ GoalPriority	Preferred	~~GoalPriority~~ Indicates the level of importance associated with reaching or sustaining a goal.
Goal.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.~~ GoalDescription	Example	~~SNOMEDCTClinicalFindings~~ Example value set for Goal descriptions.
Goal.start[x]	GoalStartEvent	Example	~~Codes describing~~ Identifies types of events that ~~can~~ might trigger the ~~initiation~~ start of a goal.
Goal.acceptance.status	~~GoalStartEvent~~ GoalAcceptStatus (a valid code from Goal acceptance status code system )	~~Goal.target.measure~~ Required	Codes to that identify whether the ~~value being tracked, e.g. body weight, blood pressure,~~ goal has been accepted or ~~hemoglobin A1c level.~~ not.
Goal.acceptance.priority	GoalPriority	Example	~~LOINCCodes~~ Indicates the level of importance associated with reaching or sustaining a goal.
Goal.target.measure	~~Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.~~ ~~Unknown~~ LOINCCodes (a valid code from LOINC )	Example	~~No details provided yet~~ This value set includes all LOINC codes
Goal.statusReason	~~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".~~ GoalStatusReason	Example	~~SNOMEDCTClinicalFindings~~ Codes to identify the reason for current lifecycle status.

Path

~~Definition~~ ValueSet

Type

~~Reference~~ Documentation

Goal.lifecycleStatus

GoalLifecycleStatus

Required

Codes that reflect the current state of a goal and whether the goal is still being targeted.

Goal.achievementStatus

~~GoalLifecycleStatus~~ GoalAchievementStatus

~~Goal.achievementStatus~~ Preferred

~~Indicates~~

Describes the progression, or lack thereof, towards the goal against the target. ~~Preferred GoalAchievementStatus~~

Goal.category

~~Codes for grouping and sorting goals.~~ GoalCategory

Example

~~GoalCategory~~

Example codes for grouping goals to use for filtering or presentation.

Goal.priority

~~The level of importance associated with a goal.~~ GoalPriority

Preferred

~~GoalPriority~~

Indicates the level of importance associated with reaching or sustaining a goal.

Goal.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.~~ GoalDescription

Example

~~SNOMEDCTClinicalFindings~~

Example value set for Goal descriptions.

Goal.start[x]

GoalStartEvent

Example

~~Codes describing~~

Identifies types of events that ~~can~~ might trigger the ~~initiation~~ start of a goal.

Goal.acceptance.status

~~GoalStartEvent~~ GoalAcceptStatus (a valid code from Goal acceptance status code system )

~~Goal.target.measure~~ Required

Codes to that identify whether the ~~value being tracked, e.g. body weight, blood pressure,~~ goal has been accepted or ~~hemoglobin A1c level.~~ not.

Goal.acceptance.priority

GoalPriority

Example

~~LOINCCodes~~

Indicates the level of importance associated with reaching or sustaining a goal.

Goal.target.measure

~~Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.~~ ~~Unknown~~ LOINCCodes (a valid code from LOINC

)

Example

~~No details provided yet~~

This value set includes all LOINC codes

Goal.statusReason

~~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".~~ GoalStatusReason

Example

~~SNOMEDCTClinicalFindings~~

Codes to identify the reason for current lifecycle status.

9.6.3.2 9.6.4.2 Constraints

id UniqueKey

Level

Location

Description

Expression

~~gol-1~~ gol-1

Rule

Goal.target

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

(detail.exists() and measure.exists()) or detail.exists().not()

9.6.4 9.6.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
achievement-status	token	in-progress \| improving \| worsening \| no-change \| achieved \| sustaining \| not-achieved \| no-progress \| not-attainable	Goal.achievementStatus
addresses	reference	Issues addressed by this goal	Goal.addresses ( Condition , RiskAssessment , MedicationRequest , NutritionOrder , Observation , Procedure , NutritionIntake , MedicationStatement , ServiceRequest )
category	token	E.g. Treatment, dietary, behavioral, etc.	Goal.category
description	token	Code or text describing goal	Goal.description
identifier	token	External Ids for this goal	Goal.identifier	30 59 Resources
lifecycle-status	token	proposed \| planned \| accepted \| active \| on-hold \| completed \| cancelled \| entered-in-error \| rejected	Goal.lifecycleStatus
patient	reference	Who this goal is intended for	Goal.subject.where(resolve() is Patient) ( Patient )	33 61 Resources
start-date	date	When goal pursuit begins	~~(Goal.start as date)~~ (Goal.start.ofType(date))
subject	reference	Who this goal is intended for	Goal.subject ( Group , Organization , Patient )
target-date	date	Reach goal on or before	~~(Goal.target.due as date)~~ (Goal.target.due.ofType(date))
target-measure	token	The parameter whose value is being tracked	Goal.target.measure