R4 Ballot #1 #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.3.0: (v3.5.0: R4 Ballot 2). #2). 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

9.6 Resource Goal - Content

Patient Care Work Group Maturity Level : 2   Trial Use Compartments : Patient

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.

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 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 resource is referenced by careplan CarePlan

9.6.3 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . Goal TU DomainResource Describes the intended objective(s) for a patient, group or organization
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier External Ids for this goal
. . . status ?! Σ 1..1 code proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected
GoalStatus ( Required )
. . . category Σ 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc.
GoalCategory Goal category ( Example )
. . . priority Σ 0..1 CodeableConcept high-priority | medium-priority | low-priority
GoalPriority Goal priority ( Preferred )
. . . description Σ 1..1 CodeableConcept Code or text describing goal
SNOMED CT Clinical Findings ( Example )
. . . subject Σ 1..1 Reference ( Patient | Group | Organization ) Who this goal is intended for
. . . start[x] Σ 0..1 When goal pursuit begins
GoalStartEvent Goal start event ( Example )
. . . . startDate date
. . . . startCodeableConcept CodeableConcept
. . . target I 0..1 BackboneElement Target outcome for the goal
+ Rule: Goal.target.measure is required if Goal.target.detail is populated
. . . . measure Σ I 0..1 CodeableConcept The parameter whose value is being tracked
LOINC Codes ( Example )
. . . . detail[x] Σ I 0..1 The target value to be achieved
. . . . . detailQuantity Quantity
. . . . . detailRange Range
. . . . . detailCodeableConcept CodeableConcept
. . . . due[x] Σ 0..1 Reach goal on or before
. . . . . dueDate date
. . . . . 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 | 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?
SNOMED CT Clinical Findings ( Example )
. . . outcomeReference 0..* Reference ( Observation ) Observation that resulted from goal

doco Documentation for this format

UML Diagram ( Legend )

Goal ( DomainResource ) Business identifiers assigned to this goal by the performer or other systems which remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..*] Indicates whether the goal has been reached and is still considered relevant (this element modifies the meaning of other elements) status : code [1..1] « Indicates whether the goal has been met and is still being targeted targeted. (Strength=Required) GoalStatus ! » Indicates a category the goal falls within category : CodeableConcept [0..*] « Codes for grouping and sorting goals goals. (Strength=Example) GoalCategory ?? » Identifies the mutually agreed level of importance associated with reaching/sustaining the goal priority : CodeableConcept [0..1] « The level of importance associated with a goal goal. (Strength=Preferred) GoalPriority ? » 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" description : CodeableConcept [1..1] « 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. (Strength=Example) SNOMED CT Clinical Findings SNOMEDCTClinicalFindings ?? » Identifies the patient, group or organization for whom the goal is being established subject : Reference [1..1] « Patient | Group | Organization » The date or event after which the goal should begin being pursued start[x] : Type [0..1] « date | CodeableConcept ; Codes describing events that can trigger the initiation of a goal goal. (Strength=Example) GoalStartEvent ?? » Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc statusDate : date [0..1] Captures the reason for the current status statusReason : string [0..1] Indicates whose goal this is - patient goal, practitioner goal, etc expressedBy : Reference [0..1] « Patient | Practitioner | RelatedPerson » The identified conditions and other health record elements that are intended to be addressed by the goal addresses : Reference [0..*] « Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment » Any comments related to the goal note : Annotation [0..*] Identifies the change (or lack of change) at the point when the status of the goal is assessed outcomeCode : CodeableConcept [0..*] « 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" months". (Strength=Example) SNOMED CT Clinical Findings SNOMEDCTClinicalFindings ?? » Details of what's changed (or not changed) outcomeReference : Reference [0..*] « Observation » Target The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level measure : CodeableConcept [0..1] « Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. (Strength=Example) LOINC LOINCCodes ?? » 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 detail[x] : Type [0..1] « Quantity | Range | CodeableConcept » Indicates either the date or the duration after start by which the goal should be met due[x] : Type [0..1] « date | Duration » Indicates what should be done by when target [0..1]

XML Template 

<Goal xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this goal --></identifier>
 <status value="[code]"/><!-- 1..1 proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected -->
 <category><!-- 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc. --></category>
 <priority><!-- 0..1 CodeableConcept high-priority | medium-priority | low-priority --></priority>
 <description><!-- 1..1 CodeableConcept Code or text describing goal --></description>
 <subject><!-- 1..1 Reference(Patient|Group|Organization) Who this goal is intended for --></subject>
 <start[x]><!-- 0..1 date|CodeableConcept When goal pursuit begins --></start[x]>
 <target>  <!-- ?? 0..1 Target outcome for the goal -->
  <measure><!-- ?? 0..1 CodeableConcept The parameter whose value is being tracked --></measure>
  <detail[x]><!-- ?? 0..1 Quantity|Range|CodeableConcept The target value to be achieved --></detail[x]>
  <due[x]><!-- 0..1 date|Duration Reach goal on or before --></due[x]>
 </target>
 <statusDate value="[date]"/><!-- 0..1 When goal status took effect -->
 <statusReason value="[string]"/><!-- 0..1 Reason for current status -->
 <expressedBy><!-- 0..1 Reference(Patient|Practitioner|RelatedPerson) Who's responsible for creating Goal? --></expressedBy>
 <addresses><!-- 0..* Reference(Condition|Observation|MedicationStatement|
   NutritionOrder|ServiceRequest|RiskAssessment) Issues addressed by this goal --></addresses>
 <note><!-- 0..* Annotation Comments about the goal --></note>
 <outcomeCode><!-- 0..* CodeableConcept What result was achieved regarding the goal? --></outcomeCode>
 <outcomeReference><!-- 0..* Reference(Observation) Observation that resulted from goal --></outcomeReference>
</Goal>

JSON Template 

{doco
  "resourceType" : "Goal",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Ids for this goal
  "status" : "<code>", // R!  proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected
  "category" : [{ CodeableConcept }], // E.g. Treatment, dietary, behavioral, etc.
  "priority" : { CodeableConcept }, // high-priority | medium-priority | low-priority
  "description" : { CodeableConcept }, // R!  Code or text describing goal
  "subject" : { Reference(Patient|Group|Organization) }, // R!  Who this goal is intended for
  // start[x]: When goal pursuit begins. One of these 2:
  "startDate" : "<date>",
  "startCodeableConcept" : { CodeableConcept },
  "target" : { // C? Target outcome for the goal
    "measure" : { CodeableConcept }, // C? The parameter whose value is being tracked
    // detail[x]: The target value to be achieved. One of these 3:
    "detailQuantity" : { Quantity },
    "detailRange" : { Range },
    "detailCodeableConcept" : { CodeableConcept },
    // due[x]: Reach goal on or before. One of these 2:
    "dueDate" : "<date>"
    "dueDuration" : { Duration }
  },
  "statusDate" : "<date>", // When goal status took effect
  "statusReason" : "<string>", // Reason for current status
  "expressedBy" : { Reference(Patient|Practitioner|RelatedPerson) }, // Who's responsible for creating Goal?
  "addresses" : [{ Reference(Condition|Observation|MedicationStatement|
   NutritionOrder|ServiceRequest|RiskAssessment) }], // Issues addressed by this goal
  "note" : [{ Annotation }], // Comments about the goal
  "outcomeCode" : [{ CodeableConcept }], // What result was achieved regarding the goal?
  "outcomeReference" : [{ Reference(Observation) }] // Observation that resulted from goal
}

Turtle Template 

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


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

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Goal.identifier [ Identifier ], ... ; # 0..* External Ids for this goal
  fhir:Goal.status [ code ]; # 1..1 proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected
  fhir:Goal.category [ CodeableConcept ], ... ; # 0..* E.g. Treatment, dietary, behavioral, etc.
  fhir:Goal.priority [ CodeableConcept ]; # 0..1 high-priority | medium-priority | low-priority
  fhir:Goal.description [ CodeableConcept ]; # 1..1 Code or text describing goal
  fhir:Goal.subject [ Reference(Patient|Group|Organization) ]; # 1..1 Who this goal is intended for
  # Goal.start[x] : 0..1 When goal pursuit begins. One of these 2
    fhir:Goal.startDate [ date ]
    fhir:Goal.startCodeableConcept [ CodeableConcept ]
  fhir:Goal.target [ # 0..1 Target outcome for the goal
    fhir:Goal.target.measure [ CodeableConcept ]; # 0..1 The parameter whose value is being tracked
    # Goal.target.detail[x] : 0..1 The target value to be achieved. One of these 3
      fhir:Goal.target.detailQuantity [ Quantity ]
      fhir:Goal.target.detailRange [ Range ]
      fhir:Goal.target.detailCodeableConcept [ CodeableConcept ]
    # Goal.target.due[x] : 0..1 Reach goal on or before. One of these 2
      fhir:Goal.target.dueDate [ date ]
      fhir:Goal.target.dueDuration [ Duration ]
  ];
  fhir:Goal.statusDate [ date ]; # 0..1 When goal status took effect
  fhir:Goal.statusReason [ string ]; # 0..1 Reason for current status
  fhir:Goal.expressedBy [ Reference(Patient|Practitioner|RelatedPerson) ]; # 0..1 Who's responsible for creating Goal?
  fhir:Goal.addresses [ Reference(Condition|Observation|MedicationStatement|NutritionOrder|ServiceRequest|
  RiskAssessment) ], ... ; # 0..* Issues addressed by this goal
  fhir:Goal.note [ Annotation ], ... ; # 0..* Comments about the goal
  fhir:Goal.outcomeCode [ CodeableConcept ], ... ; # 0..* What result was achieved regarding the goal?
  fhir:Goal.outcomeReference [ Reference(Observation) ], ... ; # 0..* Observation that resulted from goal
]

Changes since R3

Goal
Goal.subject
  • Min Cardinality changed from 0 to 1
Goal.addresses
  • Type changed from Reference(Condition|Observation|MedicationStatement|NutritionOrder|ProcedureRequest|RiskAssessment) to Reference(Condition|Observation|MedicationStatement|NutritionOrder|ServiceRequest|RiskAssessment)

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass 2 fail round-trip testing and 2 r3 resources are invalid (2 (0 errors). ). Note: these have note yet been updated to be R3 to R4 )

Structure

Name Flags Card. Type Description & Constraints doco
. . Goal TU DomainResource Describes the intended objective(s) for a patient, group or organization
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier External Ids for this goal
. . . status ?! Σ 1..1 code proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected
GoalStatus ( Required )
. . . category Σ 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc.
GoalCategory Goal category ( Example )
. . . priority Σ 0..1 CodeableConcept high-priority | medium-priority | low-priority
GoalPriority Goal priority ( Preferred )
. . . description Σ 1..1 CodeableConcept Code or text describing goal
SNOMED CT Clinical Findings ( Example )
. . . subject Σ 1..1 Reference ( Patient | Group | Organization ) Who this goal is intended for
. . . start[x] Σ 0..1 When goal pursuit begins
GoalStartEvent Goal start event ( Example )
. . . . startDate date
. . . . startCodeableConcept CodeableConcept
. . . target I 0..1 BackboneElement Target outcome for the goal
+ Rule: Goal.target.measure is required if Goal.target.detail is populated
. . . . measure Σ I 0..1 CodeableConcept The parameter whose value is being tracked
LOINC Codes ( Example )
. . . . detail[x] Σ I 0..1 The target value to be achieved
. . . . . detailQuantity Quantity
. . . . . detailRange Range
. . . . . detailCodeableConcept CodeableConcept
. . . . due[x] Σ 0..1 Reach goal on or before
. . . . . dueDate date
. . . . . 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 | 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?
SNOMED CT Clinical Findings ( Example )
. . . outcomeReference 0..* Reference ( Observation ) Observation that resulted from goal

doco Documentation for this format

UML Diagram ( Legend )

Goal ( DomainResource ) Business identifiers assigned to this goal by the performer or other systems which remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..*] Indicates whether the goal has been reached and is still considered relevant (this element modifies the meaning of other elements) status : code [1..1] « Indicates whether the goal has been met and is still being targeted targeted. (Strength=Required) GoalStatus ! » Indicates a category the goal falls within category : CodeableConcept [0..*] « Codes for grouping and sorting goals goals. (Strength=Example) GoalCategory ?? » Identifies the mutually agreed level of importance associated with reaching/sustaining the goal priority : CodeableConcept [0..1] « The level of importance associated with a goal goal. (Strength=Preferred) GoalPriority ? » 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" description : CodeableConcept [1..1] « 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. (Strength=Example) SNOMED CT Clinical Findings SNOMEDCTClinicalFindings ?? » Identifies the patient, group or organization for whom the goal is being established subject : Reference [1..1] « Patient | Group | Organization » The date or event after which the goal should begin being pursued start[x] : Type [0..1] « date | CodeableConcept ; Codes describing events that can trigger the initiation of a goal goal. (Strength=Example) GoalStartEvent ?? » Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc statusDate : date [0..1] Captures the reason for the current status statusReason : string [0..1] Indicates whose goal this is - patient goal, practitioner goal, etc expressedBy : Reference [0..1] « Patient | Practitioner | RelatedPerson » The identified conditions and other health record elements that are intended to be addressed by the goal addresses : Reference [0..*] « Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment » Any comments related to the goal note : Annotation [0..*] Identifies the change (or lack of change) at the point when the status of the goal is assessed outcomeCode : CodeableConcept [0..*] « 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" months". (Strength=Example) SNOMED CT Clinical Findings SNOMEDCTClinicalFindings ?? » Details of what's changed (or not changed) outcomeReference : Reference [0..*] « Observation » Target The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level measure : CodeableConcept [0..1] « Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. (Strength=Example) LOINC LOINCCodes ?? » 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 detail[x] : Type [0..1] « Quantity | Range | CodeableConcept » Indicates either the date or the duration after start by which the goal should be met due[x] : Type [0..1] « date | Duration » Indicates what should be done by when target [0..1]

XML Template 

<Goal xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier External Ids for this goal --></identifier>
 <status value="[code]"/><!-- 1..1 proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected -->
 <category><!-- 0..* CodeableConcept E.g. Treatment, dietary, behavioral, etc. --></category>
 <priority><!-- 0..1 CodeableConcept high-priority | medium-priority | low-priority --></priority>
 <description><!-- 1..1 CodeableConcept Code or text describing goal --></description>
 <subject><!-- 1..1 Reference(Patient|Group|Organization) Who this goal is intended for --></subject>
 <start[x]><!-- 0..1 date|CodeableConcept When goal pursuit begins --></start[x]>
 <target>  <!-- ?? 0..1 Target outcome for the goal -->
  <measure><!-- ?? 0..1 CodeableConcept The parameter whose value is being tracked --></measure>
  <detail[x]><!-- ?? 0..1 Quantity|Range|CodeableConcept The target value to be achieved --></detail[x]>
  <due[x]><!-- 0..1 date|Duration Reach goal on or before --></due[x]>
 </target>
 <statusDate value="[date]"/><!-- 0..1 When goal status took effect -->
 <statusReason value="[string]"/><!-- 0..1 Reason for current status -->
 <expressedBy><!-- 0..1 Reference(Patient|Practitioner|RelatedPerson) Who's responsible for creating Goal? --></expressedBy>
 <addresses><!-- 0..* Reference(Condition|Observation|MedicationStatement|
   NutritionOrder|ServiceRequest|RiskAssessment) Issues addressed by this goal --></addresses>
 <note><!-- 0..* Annotation Comments about the goal --></note>
 <outcomeCode><!-- 0..* CodeableConcept What result was achieved regarding the goal? --></outcomeCode>
 <outcomeReference><!-- 0..* Reference(Observation) Observation that resulted from goal --></outcomeReference>
</Goal>

JSON Template 

{doco
  "resourceType" : "Goal",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // External Ids for this goal
  "status" : "<code>", // R!  proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected
  "category" : [{ CodeableConcept }], // E.g. Treatment, dietary, behavioral, etc.
  "priority" : { CodeableConcept }, // high-priority | medium-priority | low-priority
  "description" : { CodeableConcept }, // R!  Code or text describing goal
  "subject" : { Reference(Patient|Group|Organization) }, // R!  Who this goal is intended for
  // start[x]: When goal pursuit begins. One of these 2:
  "startDate" : "<date>",
  "startCodeableConcept" : { CodeableConcept },
  "target" : { // C? Target outcome for the goal
    "measure" : { CodeableConcept }, // C? The parameter whose value is being tracked
    // detail[x]: The target value to be achieved. One of these 3:
    "detailQuantity" : { Quantity },
    "detailRange" : { Range },
    "detailCodeableConcept" : { CodeableConcept },
    // due[x]: Reach goal on or before. One of these 2:
    "dueDate" : "<date>"
    "dueDuration" : { Duration }
  },
  "statusDate" : "<date>", // When goal status took effect
  "statusReason" : "<string>", // Reason for current status
  "expressedBy" : { Reference(Patient|Practitioner|RelatedPerson) }, // Who's responsible for creating Goal?
  "addresses" : [{ Reference(Condition|Observation|MedicationStatement|
   NutritionOrder|ServiceRequest|RiskAssessment) }], // Issues addressed by this goal
  "note" : [{ Annotation }], // Comments about the goal
  "outcomeCode" : [{ CodeableConcept }], // What result was achieved regarding the goal?
  "outcomeReference" : [{ Reference(Observation) }] // Observation that resulted from goal
}

Turtle Template 

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


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

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Goal.identifier [ Identifier ], ... ; # 0..* External Ids for this goal
  fhir:Goal.status [ code ]; # 1..1 proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected
  fhir:Goal.category [ CodeableConcept ], ... ; # 0..* E.g. Treatment, dietary, behavioral, etc.
  fhir:Goal.priority [ CodeableConcept ]; # 0..1 high-priority | medium-priority | low-priority
  fhir:Goal.description [ CodeableConcept ]; # 1..1 Code or text describing goal
  fhir:Goal.subject [ Reference(Patient|Group|Organization) ]; # 1..1 Who this goal is intended for
  # Goal.start[x] : 0..1 When goal pursuit begins. One of these 2
    fhir:Goal.startDate [ date ]
    fhir:Goal.startCodeableConcept [ CodeableConcept ]
  fhir:Goal.target [ # 0..1 Target outcome for the goal
    fhir:Goal.target.measure [ CodeableConcept ]; # 0..1 The parameter whose value is being tracked
    # Goal.target.detail[x] : 0..1 The target value to be achieved. One of these 3
      fhir:Goal.target.detailQuantity [ Quantity ]
      fhir:Goal.target.detailRange [ Range ]
      fhir:Goal.target.detailCodeableConcept [ CodeableConcept ]
    # Goal.target.due[x] : 0..1 Reach goal on or before. One of these 2
      fhir:Goal.target.dueDate [ date ]
      fhir:Goal.target.dueDuration [ Duration ]
  ];
  fhir:Goal.statusDate [ date ]; # 0..1 When goal status took effect
  fhir:Goal.statusReason [ string ]; # 0..1 Reason for current status
  fhir:Goal.expressedBy [ Reference(Patient|Practitioner|RelatedPerson) ]; # 0..1 Who's responsible for creating Goal?
  fhir:Goal.addresses [ Reference(Condition|Observation|MedicationStatement|NutritionOrder|ServiceRequest|
  RiskAssessment) ], ... ; # 0..* Issues addressed by this goal
  fhir:Goal.note [ Annotation ], ... ; # 0..* Comments about the goal
  fhir:Goal.outcomeCode [ CodeableConcept ], ... ; # 0..* What result was achieved regarding the goal?
  fhir:Goal.outcomeReference [ Reference(Observation) ], ... ; # 0..* Observation that resulted from goal
]

Changes since DSTU2 Release 3

Goal
Goal.subject
  • Min Cardinality changed from 0 to 1
Goal.addresses
  • Type changed from Reference(Condition|Observation|MedicationStatement|NutritionOrder|ProcedureRequest|RiskAssessment) to Reference(Condition|Observation|MedicationStatement|NutritionOrder|ServiceRequest|RiskAssessment)

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass 2 fail round-trip testing and 2 r3 resources are invalid (2 (0 errors). ). Note: these have note yet been updated to be R3 to R4 )

 

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

9.6.3.1 Terminology Bindings

Path Definition Type Reference
Goal.status Indicates whether the goal has been met and is still being targeted targeted. Required GoalStatus
Goal.category Codes for grouping and sorting goals goals. Example GoalCategory
Goal.priority The level of importance associated with a goal goal. Preferred GoalPriority
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. Example SNOMED CT Clinical Findings SNOMEDCTClinicalFindings
Goal.start[x] Codes describing events that can trigger the initiation of a goal goal. Example GoalStartEvent
Goal.target.measure Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. Example LOINC Codes LOINCCodes
Goal.target.detail[x] Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal. Unknown No details provided yet
Goal.outcomeCode 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" months". Example SNOMED CT Clinical Findings SNOMEDCTClinicalFindings

9.6.3.2 Constraints

id Level Location Description Expression
gol-1 : On Goal.target: Rule Goal.target Goal.target.measure is required if Goal.target.detail is populated ( expression on Goal.target: (detail.exists() and measure.exists()) or detail.exists().not() )

9.6.4 Search Parameters

Search parameters for 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
category token E.g. Treatment, dietary, behavioral, etc. Goal.category
identifier token External Ids for this goal Goal.identifier 26 30 Resources
patient reference Who this goal is intended for Goal.subject Goal.subject.where(resolve() is Patient)
( Patient ) 		29 Resources
start-date date When goal pursuit begins Goal.start.as(date) (Goal.start as date)
status token proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected Goal.status
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 as date)