DSTU2 FHIR Release 3 (STU)

This page is part of the FHIR Specification (v1.0.2: DSTU (v3.0.2: STU 2). 3). 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 R3 R2

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

Detailed Descriptions for the elements in the Goal resource.

To Do Define a proper value set for this.
Goal
Definition

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

Control 1..1
Comments

Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.

Goal.identifier
Definition

This records identifiers associated with this care plan that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

Note This is a business identifer, not a resource identifier (see discussion )
Control 0..*
Type Identifier
Requirements

Need to allow connection to a wider workflow.

Goal.status
Definition

Indicates whether the goal has been reached and is still considered relevant.

Control 1..1
Terminology Binding GoalStatus ( Required )
Type code
Is Modifier true
Requirements

Allows measuring outcome and whether goal needs to be further tracked.

Summary true
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Goal.category
Definition

Indicates a category the goal falls within.

Control 0..*
Terminology Binding GoalCategory ( Example )
Type CodeableConcept
Requirements

Allows goals to be filtered and sorted.

Summary true
Goal.priority
Definition

Identifies the mutually agreed level of importance associated with reaching/sustaining the goal.

Control 0..1
Terminology Binding GoalPriority ( Preferred )
Type CodeableConcept
Requirements

Used for sorting and presenting goals.

Summary true
Comments

Extensions are available to track priorities as established by each participant (i.e. Priority from the patient's perspective, different practitioners' perspectives, family member's perspectives)

The ordinal extension on Coding can be used to convey a numerically comparable ranking to priority. (Keep in mind that different coding systems may use a "low value=important".

Goal.description
Definition

Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding".

Control 1..1
Terminology Binding SNOMED CT Clinical Findings ( Example )
Type CodeableConcept
Requirements

Without a description of what's trying to be achieved, element has no purpose.

Summary true
Comments

If no code is available, use CodeableConcept.text.

Goal.subject
Definition

Identifies the patient, group or organization for whom the goal is being established.

Control 0..1
Type Reference ( Patient | Group | Organization )
Requirements

Subject is optional to support annonymized reporting.

Summary true
Goal.start[x]
Definition

The date or event after which the goal should begin being pursued.

Control 0..1
Terminology Binding GoalStartEvent: Codes describing events that can trigger the initiation of a goal GoalStartEvent ( Example )
Type date | CodeableConcept
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

Goals can be established prior to there being an intention to start pursuing them; e.g. Goals for post-surgical recovery established prior to surgery.

Summary true
Goal.target[x] Goal.target
Definition

Indicates either the date or the duration after start by which the goal what should be met. done by when.

Control 0..1
Type date | Duration Requirements [x] Note See Choice

Allows the progress of Data Types for further information about how the goal to use [x] be monitored against an observation or due date.

Requirements Invariants Identifies when the goal should be evaluated. Defined on this element
gol-1 : Goal.target.measure is required if Goal.target.detail is populated ( expression Summary : (detail.exists() and measure.exists()) or detail.exists().not(), xpath: (exists(f:*[starts-with(local-name(.), 'detail')]) and exists(f:measure)) or not(exists(f:*[starts-with(local-name(.), 'detail')])))
Affect this element true
Goal.category Goal.target.measure
Definition

Indicates a category the goal falls within. The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

Control 0..* 0..1
Terminology Binding GoalCategory: LOINC Codes for grouping and sorting goals ( Example )
Type CodeableConcept
Requirements Summary Allows goals to be filtered and sorted. true
Summary Invariants true Affect this element
gol-1 : Goal.target.measure is required if Goal.target.detail is populated ( expression : (detail.exists() and measure.exists()) or detail.exists().not(), xpath: (exists(f:*[starts-with(local-name(.), 'detail')]) and exists(f:measure)) or not(exists(f:*[starts-with(local-name(.), 'detail')])))
Goal.description Goal.target.detail[x]
Definition

Human-readable description The target value of a specific desired objective the focus to be achieved to signify the fulfillment of care. 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.

Control 1..1 0..1
Terminology Binding GoalTargetDetail :
Type string Quantity | Range | CodeableConcept
Requirements [x] Note Without a description See Choice of what's trying Data Types for further information about how to be achieved, element has no purpose. use [x]
Summary true
Invariants Affect this element
gol-1 : Goal.target.measure is required if Goal.target.detail is populated ( expression : (detail.exists() and measure.exists()) or detail.exists().not(), xpath: (exists(f:*[starts-with(local-name(.), 'detail')]) and exists(f:measure)) or not(exists(f:*[starts-with(local-name(.), 'detail')])))
Goal.status Goal.target.due[x]
Definition

Indicates whether either the date or the duration after start by which the goal has been reached and is still considered relevant. should be met.

Control 1..1 Binding GoalStatus: Indicates whether the goal has been met and is still being targeted ( Required ) 0..1
Type code date | Duration
Is Modifier [x] Note true See Choice of Data Types for further information about how to use [x]
Requirements

Allows measuring outcome and whether Identifies when the goal needs to should be further tracked. evaluated.

Summary true
Goal.statusDate
Definition

Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc.

Control 0..1
Type date
Summary true
Comments

To see the date for past statuses, query history.

Goal.statusReason
Definition

Captures the reason for the current status.

Control 0..1
Binding GoalStatusReason: Codes to identify the reason for a goal's current status ( Example ) Type CodeableConcept string
Comments

This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others.

Goal.author Goal.expressedBy
Definition

Indicates whose goal this is - patient goal, practitioner goal, etc.

Control 0..1
Type Reference ( Patient | Practitioner | RelatedPerson )
Summary true
Comments

This is the individual reponsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.).

Goal.priority Definition Identifies the mutually agreed level of importance associated with reaching/sustaining the goal. Control 0..1 Binding GoalPriority: The level of importance associated with a goal ( Preferred ) Type CodeableConcept Requirements Used for sorting and presenting goals. Summary true Comments Extensions are available to track priorities as established by each participant (i.e. Priority from the patient's perspective, different practitioners' perspectives, family member's perspectives) The ordinal extension on Coding can be used to convey a numerically comparable ranking to priority. (Keep in mind that different coding systems may use a "low value=important". Goal.addresses
Definition

The identified conditions and other health record elements that are intended to be addressed by the goal.

Control 0..*
Type Reference ( Condition | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessment )
Requirements

Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable.

Goal.note
Definition

Any comments related to the goal.

Control 0..*
Type Annotation
Requirements

There's a need to capture information about the goal that doesn't actually describe the goal.

Comments

May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.

Goal.outcome Goal.outcomeCode
Definition

Identifies the change (or lack of change) at the point where when the status of the goal was deepmed to be cancelled or achieved. is assessed.

Control 0..*
Terminology Binding SNOMED CT Clinical Findings ( Example )
Type CodeableConcept
Requirements

Outcome tracking is a key aspect of care planning.

Comments

Note that this should not duplicate the goal status.

Goal.outcome.result[x] Goal.outcomeReference
Definition

Details of what's changed (or not changed).

Control 0..1 Binding GoalOutcome : 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" 0..*
Type CodeableConcept | Reference ( Observation )
[x] Note Requirements See Choice

Outcome tracking is a key aspect of Data Types for further information about how care planning.

Comments

The goal outcome is independent of the outcome of the related activities. For example, if the Goal is to use [x] achieve a target body weight of 150 lb and a care plan activity is defined to diet, then the care plan’s activity outcome could be calories consumed whereas goal outcome is an observation for the actual body weight measured.