Release 4B Snapshot 3: Connectathon 32 Base

This page is part of the FHIR Specification (v4.3.0: R4B - STU (v5.0.0-snapshot3: R5 Snapshot #3, to support Connectathon 32 ). 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 icon Work Group Maturity Level : 2   Trial Use Security Category : Patient 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 .

Goal does not include the legal Advance Directives, which should be represented with the Consent resource 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

This resource is referenced by

9.6.4 Resource Content

Structure

Name icon Flags icon Card. icon Type icon Description & Constraints icon doco icon
. . 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

. . . lifecycleStatus ?! Σ 1..1 code proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
GoalLifecycleStatus ( Required )
. . . achievementStatus Σ 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
GoalAchievementStatus ( Preferred )
. . . continuous 0..1 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
GoalPriority ( 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 ( Example )
. . . . startDate date
. . . . startCodeableConcept CodeableConcept
. . . target I 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
LOINC Codes ( Example )
. . . . detail[x] Σ I C 0..1 The target value to be achieved
GoalTargetDetail ( Example )
. . . . . 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 status took effect
. . . statusReason 0..1 string Reason for current status
. . expressedBy . source Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam ) Who's responsible for creating Goal?
. . . addresses 0..* Reference ( Condition | Observation | MedicationStatement MedicationUsage | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment ) Issues addressed by this goal

. . . note 0..* Annotation Comments about the goal

. . outcomeCode . outcome 0..* CodeableConcept CodeableReference ( Observation ) 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 icon

See the Extensions for this resource

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..*] The state of the goal throughout its lifecycle (this element modifies the meaning of other elements) lifecycleStatus : code [1..1] « null (Strength=Required) GoalLifecycleStatus ! » Describes the progression, or lack thereof, towards the goal against the target achievementStatus : CodeableConcept [0..1] « null (Strength=Preferred) GoalAchievementStatus ? » Indicates a category the goal falls within category : CodeableConcept [0..*] « null (Strength=Example) GoalCategory ?? » After meeting the goal, ongoing activity is needed to sustain the goal objective continuous : boolean [0..1] Identifies the mutually agreed level of importance associated with reaching/sustaining the goal priority : CodeableConcept [0..1] « null (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] « null (Strength=Example) 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] : Element DataType [0..1] « date | CodeableConcept ; null (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 source : Reference [0..1] « Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam » The identified conditions and other health record elements that are intended to be addressed by the goal addresses : Reference [0..*] « Condition | Observation | MedicationUsage | MedicationStatement MedicationRequest | 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 outcome : CodeableConcept CodeableReference [0..*] « Observation ; null (Strength=Example) SNOMEDCTClinicalFindings ?? » Details of what's changed (or not changed) outcomeReference : Reference [0..*] « Observation SNOMEDCTClinicalFindings ?? » Target The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level measure : CodeableConcept [0..1] « null (Strength=Example) LOINCCodes ?? » « This element has or is affected by some invariants C » 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] : Element DataType [0..1] « Quantity | Range | CodeableConcept | string | boolean | integer | Ratio ; null (Strength=Example) GoalTargetDetail?? » « This element has or is affected by some invariants C » Indicates either the date or the duration after start by which the goal should be met due[x] : Element DataType [0..1] « date | Duration » Indicates what should be done by when target [0..*]

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>
 <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><!-- 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><!-- 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>
  <|

 <target>  <!-- I 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>
 <statusDate value="[date]"/><!-- 0..1 When goal status took effect -->
 <statusReason value="[string]"/><!-- 0..1 Reason for current status -->
 <|
   </expressedBy>
 <|
   </addresses>

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

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

 <outcome><!-- 0..* CodeableReference(Observation) What result was achieved regarding the goal? --></outcome>

</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
  "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 },
  "
    "

  "target" : [{ // I 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 status took effect
  "statusReason" : "<string>", // Reason for current status
  "|

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

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

  "addresses" : [{ Reference(Condition|MedicationRequest|MedicationUsage|
   NutritionOrder|Observation|RiskAssessment|ServiceRequest) }], // Issues addressed by this goal
  "note" : [{ Annotation }], // Comments about the goal
  "
  "

  "outcome" : [{ CodeableReference(Observation) }] // What result was achieved regarding the 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.lifecycleStatus [ code ]; # 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  fhir:Goal.achievementStatus [ CodeableConcept ]; # 0..1 in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
  fhir:Goal.category [ CodeableConcept ], ... ; # 0..* E.g. Treatment, dietary, behavioral, etc.
  fhir:Goal.continuous [ boolean ]; # 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective

  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(Group|Organization|Patient) ]; # 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:
    fhir:
    # . One of these 7

  fhir:Goal.target [ # 0..* I Target outcome for the goal
    fhir:Goal.target.measure [ CodeableConcept ]; # 0..1 I The parameter whose value is being tracked
    # Goal.target.detail[x] : 0..1 I The target value to be achieved. One of these 7

      fhir:Goal.target.detailQuantity [ Quantity ]
      fhir:Goal.target.detailRange [ Range ]
      fhir:Goal.target.detailCodeableConcept [ CodeableConcept ]
      fhir:Goal.target.detailString [ string ]
      fhir:Goal.target.detailBoolean [ boolean ]
      fhir:Goal.target.detailInteger [ integer ]
      fhir:Goal.target.detailRatio [ Ratio ]
    # 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:
  fhir:|
  

  fhir:Goal.source [ Reference(CareTeam|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who's responsible for creating Goal?
  fhir:Goal.addresses [ Reference(Condition|MedicationRequest|MedicationUsage|NutritionOrder|Observation|
  RiskAssessment|ServiceRequest) ], ... ; # 0..* Issues addressed by this goal
  fhir:Goal.note [ Annotation ], ... ; # 0..* Comments about the goal
  fhir:
  fhir:

  fhir:Goal.outcome [ CodeableReference(Observation) ], ... ; # 0..* What result was achieved regarding the goal?

]

Changes since R4

Goal
Goal.continuous
  • No Changes Added Element
Goal.source
  • Added Element
Goal.addresses
  • Type Reference: Added Target Types MedicationUsage, MedicationRequest
  • Type Reference: Removed Target Type MedicationStatement
  • Type Reference: Removed Target Type MedicationStatement
Goal.outcome
  • Added Element
Goal.expressedBy
  • deleted
Goal.outcomeCode
  • deleted
Goal.outcomeReference
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4 See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.)

Structure

Name icon Flags icon Card. icon Type icon Description & Constraints icon doco icon
. . 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

. . . lifecycleStatus ?! Σ 1..1 code proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
GoalLifecycleStatus ( Required )
. . . achievementStatus Σ 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
GoalAchievementStatus ( Preferred )
. . . continuous 0..1 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
GoalPriority ( 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 ( Example )
. . . . startDate date
. . . . startCodeableConcept CodeableConcept
. . . target I 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
LOINC Codes ( Example )
. . . . detail[x] Σ I C 0..1 The target value to be achieved
GoalTargetDetail ( Example )
. . . . . 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 status took effect
. . . statusReason 0..1 string Reason for current status
. . expressedBy . source Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam ) Who's responsible for creating Goal?
. . . addresses 0..* Reference ( Condition | Observation | MedicationStatement MedicationUsage | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment ) Issues addressed by this goal

. . . note 0..* Annotation Comments about the goal

. . outcomeCode . outcome 0..* CodeableConcept CodeableReference ( Observation ) 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 icon

See the Extensions for this resource

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..*] The state of the goal throughout its lifecycle (this element modifies the meaning of other elements) lifecycleStatus : code [1..1] « null (Strength=Required) GoalLifecycleStatus ! » Describes the progression, or lack thereof, towards the goal against the target achievementStatus : CodeableConcept [0..1] « null (Strength=Preferred) GoalAchievementStatus ? » Indicates a category the goal falls within category : CodeableConcept [0..*] « null (Strength=Example) GoalCategory ?? » After meeting the goal, ongoing activity is needed to sustain the goal objective continuous : boolean [0..1] Identifies the mutually agreed level of importance associated with reaching/sustaining the goal priority : CodeableConcept [0..1] « null (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] « null (Strength=Example) 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] : Element DataType [0..1] « date | CodeableConcept ; null (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 source : Reference [0..1] « Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam » The identified conditions and other health record elements that are intended to be addressed by the goal addresses : Reference [0..*] « Condition | Observation | MedicationUsage | MedicationStatement MedicationRequest | 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 outcome : CodeableConcept CodeableReference [0..*] « Observation ; null (Strength=Example) SNOMEDCTClinicalFindings ?? » Details of what's changed (or not changed) outcomeReference : Reference [0..*] « Observation SNOMEDCTClinicalFindings ?? » Target The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level measure : CodeableConcept [0..1] « null (Strength=Example) LOINCCodes ?? » « This element has or is affected by some invariants C » 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] : Element DataType [0..1] « Quantity | Range | CodeableConcept | string | boolean | integer | Ratio ; null (Strength=Example) GoalTargetDetail?? » « This element has or is affected by some invariants C » Indicates either the date or the duration after start by which the goal should be met due[x] : Element DataType [0..1] « date | Duration » Indicates what should be done by when target [0..*]

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>
 <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><!-- 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><!-- 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>
  <|

 <target>  <!-- I 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>
 <statusDate value="[date]"/><!-- 0..1 When goal status took effect -->
 <statusReason value="[string]"/><!-- 0..1 Reason for current status -->
 <|
   </expressedBy>
 <|
   </addresses>

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

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

 <outcome><!-- 0..* CodeableReference(Observation) What result was achieved regarding the goal? --></outcome>

</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
  "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 },
  "
    "

  "target" : [{ // I 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 status took effect
  "statusReason" : "<string>", // Reason for current status
  "|

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

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

  "addresses" : [{ Reference(Condition|MedicationRequest|MedicationUsage|
   NutritionOrder|Observation|RiskAssessment|ServiceRequest) }], // Issues addressed by this goal
  "note" : [{ Annotation }], // Comments about the goal
  "
  "

  "outcome" : [{ CodeableReference(Observation) }] // What result was achieved regarding the 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.lifecycleStatus [ code ]; # 1..1 proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
  fhir:Goal.achievementStatus [ CodeableConcept ]; # 0..1 in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
  fhir:Goal.category [ CodeableConcept ], ... ; # 0..* E.g. Treatment, dietary, behavioral, etc.
  fhir:Goal.continuous [ boolean ]; # 0..1 After meeting the goal, ongoing activity is needed to sustain the goal objective

  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(Group|Organization|Patient) ]; # 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:
    fhir:
    # . One of these 7

  fhir:Goal.target [ # 0..* I Target outcome for the goal
    fhir:Goal.target.measure [ CodeableConcept ]; # 0..1 I The parameter whose value is being tracked
    # Goal.target.detail[x] : 0..1 I The target value to be achieved. One of these 7

      fhir:Goal.target.detailQuantity [ Quantity ]
      fhir:Goal.target.detailRange [ Range ]
      fhir:Goal.target.detailCodeableConcept [ CodeableConcept ]
      fhir:Goal.target.detailString [ string ]
      fhir:Goal.target.detailBoolean [ boolean ]
      fhir:Goal.target.detailInteger [ integer ]
      fhir:Goal.target.detailRatio [ Ratio ]
    # 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:
  fhir:|
  

  fhir:Goal.source [ Reference(CareTeam|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who's responsible for creating Goal?
  fhir:Goal.addresses [ Reference(Condition|MedicationRequest|MedicationUsage|NutritionOrder|Observation|
  RiskAssessment|ServiceRequest) ], ... ; # 0..* Issues addressed by this goal
  fhir:Goal.note [ Annotation ], ... ; # 0..* Comments about the goal
  fhir:
  fhir:

  fhir:Goal.outcome [ CodeableReference(Observation) ], ... ; # 0..* What result was achieved regarding the goal?

]

Changes since Release 4

Goal
Goal.continuous
  • No Changes Added Element
Goal.source
  • Added Element
Goal.addresses
  • Type Reference: Added Target Types MedicationUsage, MedicationRequest
  • Type Reference: Removed Target Type MedicationStatement
  • Type Reference: Removed Target Type MedicationStatement
Goal.outcome
  • Added Element
Goal.expressedBy
  • deleted
Goal.outcomeCode
  • deleted
Goal.outcomeReference
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4 See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. All tests pass round-trip testing and all r3 resources are valid.)

 

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

9.6.4.1 Terminology Bindings

Path Definition Type Reference
Goal.lifecycleStatus

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

Required GoalLifecycleStatus
Goal.achievementStatus

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

Preferred GoalAchievementStatus
Goal.category

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

Example GoalCategory
Goal.priority

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

Preferred GoalPriority
Goal.description

This value set includes all the "Clinical finding" SNOMED CT icon codes - concepts where concept is-a 404684003 (Clinical finding (finding)).

Example SNOMEDCTClinicalFindings
Goal.start[x]

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

Example GoalStartEvent
Goal.target.measure

This value set includes all LOINC codes

Example LOINCCodes (a valid code from LOINC icon )
Goal.target.detail[x] Example ??
Goal.outcomeCode Goal.outcome

This value set includes all the "Clinical finding" SNOMED CT icon codes - concepts where concept is-a 404684003 (Clinical finding (finding)).

Example SNOMEDCTClinicalFindings

9.6.4.2 Constraints

id UniqueKey Level Location Description Expression
gol-1 img  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()

9.6.5 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
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 , MedicationUsage , 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 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 Resources
start-date date When goal pursuit begins (Goal.start as 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)