Release 4 4B

This page is part of the FHIR Specification (v4.0.1: R4 (v4.3.0: R4B - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). ). 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 R4B R4 R3 R2

9.6 Resource Goal - Content

Patient Care 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 .

9.6.3 References

This resource is referenced by CarePlan .

This resource does not implement any patterns.

9.6.3 9.6.4 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
. . . 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
Goal achievement status GoalAchievementStatus ( Preferred )
. . . priority Σ 0..1 CodeableConcept high-priority | medium-priority | low-priority
Goal 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
Goal start event GoalStartEvent ( Example )
. . . . startDate date
. . . . startCodeableConcept CodeableConcept
. . . target I 0..* 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
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 Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson ) Who's responsible for creating Goal?
. . . addresses 0..* Reference ( Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment ) Issues addressed by this goal
. . . note 0..* Annotation Comments about the goal
. . . outcomeCode 0..* CodeableConcept What result was achieved regarding the goal?
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..*] The state of the goal throughout its lifecycle (this element modifies the meaning of other elements) lifecycleStatus : code [1..1] « Codes that reflect the current state of a goal and whether the goal is still being targeted. null (Strength=Required) GoalLifecycleStatus ! » Describes the progression, or lack thereof, towards the goal against the target achievementStatus : CodeableConcept [0..1] « Indicates the progression, or lack thereof, towards the goal against the target. null (Strength=Preferred) GoalAchievementStatus ? » Indicates a category the goal falls within category : CodeableConcept [0..*] « Codes for grouping and sorting goals. null (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. 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] « 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. 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] : Type Element [0..1] « date | CodeableConcept ; Codes describing events that can trigger the initiation of a goal. 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 : Reference [0..1] « Patient | Practitioner | PractitionerRole | 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". null (Strength=Example) 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. null (Strength=Example) 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 Element [0..1] « Quantity | Range | CodeableConcept | string | boolean | integer | Ratio ; null (Strength=Example) GoalTargetDetail?? » Indicates either the date or the duration after start by which the goal should be met due[x] : Type Element [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>
 <priority><!-- 0..1 CodeableConcept high-priority | medium-priority | low-priority --></priority>
 <description><!-- 1..1 CodeableConcept Code or text describing goal --></description>
 <</subject>

 <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]>
 <target>  <!-- ?? 0..* Target outcome for the goal -->
  <measure><!-- ?? 0..1 CodeableConcept The parameter whose value is being tracked --></measure>
  <detail[x]><!-- ?? 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><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who's responsible for creating Goal? --></expressedBy>
 <|
   </addresses>

 <addresses><!-- 0..* Reference(Condition|MedicationStatement|NutritionOrder|
   Observation|RiskAssessment|ServiceRequest) 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
  "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.
  "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" : [{ // 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 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
  "expressedBy" : { Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who's responsible for creating Goal?
  "|
   

  "addresses" : [{ Reference(Condition|MedicationStatement|NutritionOrder|
   Observation|RiskAssessment|ServiceRequest) }], // 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.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.priority [ CodeableConcept ]; # 0..1 high-priority | medium-priority | low-priority
  fhir:Goal.description [ CodeableConcept ]; # 1..1 Code or text describing goal
  fhir:

  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:Goal.target [ # 0..* 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 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:Goal.expressedBy [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who's responsible for creating Goal?
  fhir:|
  

  fhir:Goal.addresses [ Reference(Condition|MedicationStatement|NutritionOrder|Observation|RiskAssessment|
  ServiceRequest) ], ... ; # 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 R4

Goal Goal.lifecycleStatus Added Mandatory Element Goal.achievementStatus
  • Added Element Goal.subject Min Cardinality changed from 0 to 1 Goal.target Max Cardinality changed from 1 to * Goal.target.detail[x] Add Types string, boolean, integer, Ratio Goal.expressedBy Type Reference: Added Target Type PractitionerRole Goal.addresses Type Reference: Added Target Type ServiceRequest Type Reference: Removed Target Type ProcedureRequest Goal.status deleted No Changes

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 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
. . . 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
Goal achievement status GoalAchievementStatus ( Preferred )
. . . priority Σ 0..1 CodeableConcept high-priority | medium-priority | low-priority
Goal 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
Goal start event GoalStartEvent ( Example )
. . . . startDate date
. . . . startCodeableConcept CodeableConcept
. . . target I 0..* 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
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 Σ 0..1 Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson ) Who's responsible for creating Goal?
. . . addresses 0..* Reference ( Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment ) Issues addressed by this goal
. . . note 0..* Annotation Comments about the goal
. . . outcomeCode 0..* CodeableConcept What result was achieved regarding the goal?
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..*] The state of the goal throughout its lifecycle (this element modifies the meaning of other elements) lifecycleStatus : code [1..1] « Codes that reflect the current state of a goal and whether the goal is still being targeted. null (Strength=Required) GoalLifecycleStatus ! » Describes the progression, or lack thereof, towards the goal against the target achievementStatus : CodeableConcept [0..1] « Indicates the progression, or lack thereof, towards the goal against the target. null (Strength=Preferred) GoalAchievementStatus ? » Indicates a category the goal falls within category : CodeableConcept [0..*] « Codes for grouping and sorting goals. null (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. 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] « 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. 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] : Type Element [0..1] « date | CodeableConcept ; Codes describing events that can trigger the initiation of a goal. 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 : Reference [0..1] « Patient | Practitioner | PractitionerRole | 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". null (Strength=Example) 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. null (Strength=Example) 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 Element [0..1] « Quantity | Range | CodeableConcept | string | boolean | integer | Ratio ; null (Strength=Example) GoalTargetDetail?? » Indicates either the date or the duration after start by which the goal should be met due[x] : Type Element [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>
 <priority><!-- 0..1 CodeableConcept high-priority | medium-priority | low-priority --></priority>
 <description><!-- 1..1 CodeableConcept Code or text describing goal --></description>
 <</subject>

 <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]>
 <target>  <!-- ?? 0..* Target outcome for the goal -->
  <measure><!-- ?? 0..1 CodeableConcept The parameter whose value is being tracked --></measure>
  <detail[x]><!-- ?? 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><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who's responsible for creating Goal? --></expressedBy>
 <|
   </addresses>

 <addresses><!-- 0..* Reference(Condition|MedicationStatement|NutritionOrder|
   Observation|RiskAssessment|ServiceRequest) 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
  "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.
  "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" : [{ // 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 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
  "expressedBy" : { Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who's responsible for creating Goal?
  "|
   

  "addresses" : [{ Reference(Condition|MedicationStatement|NutritionOrder|
   Observation|RiskAssessment|ServiceRequest) }], // 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.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.priority [ CodeableConcept ]; # 0..1 high-priority | medium-priority | low-priority
  fhir:Goal.description [ CodeableConcept ]; # 1..1 Code or text describing goal
  fhir:

  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:Goal.target [ # 0..* 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 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:Goal.expressedBy [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who's responsible for creating Goal?
  fhir:|
  

  fhir:Goal.addresses [ Reference(Condition|MedicationStatement|NutritionOrder|Observation|RiskAssessment|
  ServiceRequest) ], ... ; # 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 Release 3 4

Goal Goal.lifecycleStatus Added Mandatory Element Goal.achievementStatus Added Element Goal.subject Min Cardinality changed from 0 to 1 Goal.target Max Cardinality changed from 1 to * Goal.target.detail[x] Add Types string, boolean, integer, Ratio Goal.expressedBy
  • Type Reference: Added Target Type PractitionerRole Goal.addresses Type Reference: Added Target Type ServiceRequest Type Reference: Removed Target Type ProcedureRequest Goal.status deleted No Changes

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 definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions & the dependency analysis

9.6.3.1 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 Indicates the progression, or lack thereof, towards the goal against the target. Preferred GoalAchievementStatus
Goal.category Codes for grouping and sorting goals. Example GoalCategory
Goal.priority The level of importance associated with a 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 SNOMEDCTClinicalFindings
Goal.start[x] Codes describing events that can trigger the initiation of a goal. Example GoalStartEvent
Goal.target.measure Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. Example 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 Example 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". Example SNOMEDCTClinicalFindings

9.6.3.2 9.6.4.2 Constraints

id Level Location Description Expression
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. 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
category token E.g. Treatment, dietary, behavioral, etc. Goal.category
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)