Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm
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Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm, published by HL7 International / Human and Social Services. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/eLTSS/ and changes regularly. See the Directory of published versions

Resource Profile: eLTSS Goal Profile

Official URL: http://hl7.org/fhir/us/eltss/StructureDefinition/Goal-eltss Version: 2.0.0
Standards status: Trial-use Maturity Level: 2 Computable Name: Goal_eltss

Goal resource mapping for eLTSS

Implementer mapping guidance

The following aids in finding the location of eLTSS data elements. See R4 FHIR Mapping page for complete guidance, here we are providing a subset of fields for convenience.

eLTSS Grouping eLTSS Data Element Name Data Element Definition (includes examples, expected list of values and usage note where applicable) FHIR R4 Resource Element(s) FHIR R4 Resource Element Cardinality (with US Core Constraints) Additional Mapping Details
Goals & Strengths Goal A statement of a desired result that the person wants to achieve. CarePlan → goal(Goal)

Goal → description → text		 CarePlan
...goal(Goal) 0..*
......description 1
.........text 1
......subject(Patient) 1		 1) Will use CarePlan → goal to reference the Goal for the care plan being developed.
2) description is required by both FHIR and US Core, and is a CodableConcept whose text element, per US Core, must include a text description of the goal.
3) Each goal should go into a separate Goal element so each can potentially reference a step or action(s), or a service(s) that addresses the goal.
4) A Goal can be referenced from a Step or Action or from a service. For a goal related to a step or action, use extension(pertainsToGoal). For a service request specific goal, also use extension(pertainsToGoal). Logically, these goals are exclusive to each other and the same goal isn't duplicated at both levels.
5) US Core requires the use of Goal → Subject to reference back to the Patient.
Goals & Strengths Step or Action A planned measurable step or action that needs to be taken to accomplish a goal identified by the person. CarePlan → activity
→ reference(Resource) → note
→ text → extension(pertainsToGoal)		 CarePlan
...activity 0..*
......reference(Resource) 0..1
.........note 0..*
............text 1
.........extension(pertainsToGoal)		 1) CarePlan includes activity → reference, which can be a reference to ServiceRequest, Task or other Resource.
2) ServiceRequest would be used when the Step or Action is a task under a service. If the Step or Action is an informal support or an activity being undertaken by the patient/care recipient, the Task Resource, similar to a Patient Task used in the Gravity SDOH IG, can be used.
3) activity → reference(Resource) is linked to the Goal the step or action addresses through the pertainsToGoal Extension in the referenced activity.
4) activity → reference(Resource) includes a performer, author, participant with type or other data element that can be used to reference who is responsible for performing the step or action, such as to indicate that the person or a related person is responsible.
5) text is where the Step or Action text would be provided.
6) text is required by FHIR if note is provided.
7) Note that a stated goal may lead directly to a service, and not necessarily to an explicit Step or Action. For example, a person's goal could be to attend church regularly, and this would be achieved through a transportation service.
Data Requirements Not Specific to eLTSS Dataset Data Elements
This section documents data elements that are mandatory per FHIR XML schemas or US Core requirements, but that do not align with individual eLTSS Dataset data elements.
FHIR Data Element Name
Requirement Source		 Data Element Definition FHIR R4 Resource Element(s) FHIR R4 Resource Element Cardinality (with US Core Constraints) Additional Mapping Details
Goal LifecycleStatus
FHIR
US Core		 The state of the goal throughout its lifecycle. Goal → lifecycleStatus Goal 0..*
...lifecycleStatus 1		 1) lifecycleStatus is required by both FHIR and US Core, and must use the GoalStatus value set which has values: proposed, accepted, in-progress, etc.
Goal Subject
FHIR
US Core		 Identifies the patient, group or organization for whom the goal is being established. Goal → subject(Patient) Goal
...subject 1		 1) subject is required by both FHIR and US Core, and is a reference to a Patient.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreGoalProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..* USCoreGoalProfile Describes the intended objective(s) for a patient, group or organization
... description 1..1 CodeableConcept Goal
... subject 1..1 Reference(Patient_eltss) (USCDI) Who this goal is intended for
... Slices for start[x] 0..1 date, CodeableConcept (USCDI) When goal pursuit begins
Slice: Unordered, Open by type:$this
.... start[x]:startDate S 0..1 date S Start-date of the duration of time when the goal is due. End-date is found in dueDate
... addresses 0..* Reference(Condition_eltss | Observation_eltss | ServiceRequest_eltss | RiskAssessment_eltss | NutritionOrder | MedicationStatement) Issues addressed by this goal

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron