QI-Core Implementation Guide
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QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 6.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

Resource Profile: QICore Goal

Official URL: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-goal Version: 6.0.0
Active as of 2018-08-22 Computable Name: QICoreGoal

Profile of Goal for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

Usage

See the patterns page for implementation and usage patterns.

Examples

Weight Loss Example

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..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... subject 1..1Reference(QICore Patient)(QI-Core)(USCDI) Who this goal is intended for
... start[x] Σ0..1(QI-Core)(USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.

.... startDatedate
.... startCodeableConceptCodeableConcept
... target 0..*BackboneElement(QI-Core)(USCDI) Target outcome for the goal

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... lifecycleStatus ?!SΣ1..1code(USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... subject SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who this goal is intended for
... start[x] SΣ0..1(QI-Core)(USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.

.... startDatedate
... target SC0..*BackboneElement(QI-Core)(USCDI) Target outcome for the goal
gol-1: Goal.target.measure is required if Goal.target.detail is populated
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... due[x] SΣ0..1(USCDI) Reach goal on or before
..... dueDatedate

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Goal.lifecycleStatusrequiredGoalLifecycleStatus
http://hl7.org/fhir/ValueSet/goal-status
from the FHIR Standard
Goal.descriptionextensibleUSCoreGoalCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorGoalIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorGoalIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorGoalIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorGoalIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceGoalA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gol-1errorGoal.targetGoal.target.measure is required if Goal.target.detail is populated
: (detail.exists() and measure.exists()) or detail.exists().not()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal Ids for this goal
... lifecycleStatus ?!SΣ1..1code(USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.

... category Σ0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example): Codes for grouping and sorting goals.


... priority Σ0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): The level of importance associated with a goal.

... description SΣ1..1CodeableConcept(USCDI) Code or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal

... subject SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who this goal is intended for
... start[x] SΣ0..1(QI-Core)(USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.

.... startDatedate S
.... startCodeableConceptCodeableConcept
... target SC0..*BackboneElement(QI-Core)(USCDI) Target outcome for the goal
gol-1: Goal.target.measure is required if Goal.target.detail is populated
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure ΣC0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

.... detail[x] ΣC0..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] SΣ0..1(USCDI) Reach goal on or before
..... dueDatedate S
..... dueDurationDuration
... statusDate Σ0..1dateWhen goal status took effect
... statusReason 0..1stringReason for current status
... expressedBy Σ0..1Reference(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..*AnnotationComments about the goal
... outcomeCode 0..*CodeableConceptWhat result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (example): 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".


... outcomeReference 0..*Reference(Observation)Observation that resulted from goal

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Goal.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Goal.lifecycleStatusrequiredGoalLifecycleStatus
http://hl7.org/fhir/ValueSet/goal-status
from the FHIR Standard
Goal.achievementStatuspreferredGoalAchievementStatus
http://hl7.org/fhir/ValueSet/goal-achievement
from the FHIR Standard
Goal.categoryexampleGoalCategory
http://hl7.org/fhir/ValueSet/goal-category
from the FHIR Standard
Goal.prioritypreferredGoalPriority
http://hl7.org/fhir/ValueSet/goal-priority
from the FHIR Standard
Goal.descriptionextensibleUSCoreGoalCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
from the FHIR Standard
Goal.target.measureexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Goal.target.detail[x]example
Goal.outcomeCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorGoalIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorGoalIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorGoalIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorGoalIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceGoalA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gol-1errorGoal.targetGoal.target.measure is required if Goal.target.detail is populated
: (detail.exists() and measure.exists()) or detail.exists().not()

This structure is derived from USCoreGoalProfile

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

Differential View

This structure is derived from USCoreGoalProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... subject 1..1Reference(QICore Patient)(QI-Core)(USCDI) Who this goal is intended for
... start[x] Σ0..1(QI-Core)(USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.

.... startDatedate
.... startCodeableConceptCodeableConcept
... target 0..*BackboneElement(QI-Core)(USCDI) Target outcome for the goal

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
from the FHIR Standard

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... lifecycleStatus ?!SΣ1..1code(USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... subject SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who this goal is intended for
... start[x] SΣ0..1(QI-Core)(USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.

.... startDatedate
... target SC0..*BackboneElement(QI-Core)(USCDI) Target outcome for the goal
gol-1: Goal.target.measure is required if Goal.target.detail is populated
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... due[x] SΣ0..1(USCDI) Reach goal on or before
..... dueDatedate

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Goal.lifecycleStatusrequiredGoalLifecycleStatus
http://hl7.org/fhir/ValueSet/goal-status
from the FHIR Standard
Goal.descriptionextensibleUSCoreGoalCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorGoalIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorGoalIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorGoalIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorGoalIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceGoalA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gol-1errorGoal.targetGoal.target.measure is required if Goal.target.detail is populated
: (detail.exists() and measure.exists()) or detail.exists().not()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*USCoreGoalProfileDescribes the intended objective(s) for a patient, group or organization
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier 0..*IdentifierExternal Ids for this goal
... lifecycleStatus ?!SΣ1..1code(USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.

... category Σ0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example): Codes for grouping and sorting goals.


... priority Σ0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred): The level of importance associated with a goal.

... description SΣ1..1CodeableConcept(USCDI) Code or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal

... subject SΣ1..1Reference(QICore Patient)(QI-Core)(USCDI) Who this goal is intended for
... start[x] SΣ0..1(QI-Core)(USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.

.... startDatedate S
.... startCodeableConceptCodeableConcept
... target SC0..*BackboneElement(QI-Core)(USCDI) Target outcome for the goal
gol-1: Goal.target.measure is required if Goal.target.detail is populated
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure ΣC0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

.... detail[x] ΣC0..1The target value to be achieved
Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] SΣ0..1(USCDI) Reach goal on or before
..... dueDatedate S
..... dueDurationDuration
... statusDate Σ0..1dateWhen goal status took effect
... statusReason 0..1stringReason for current status
... expressedBy Σ0..1Reference(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..*AnnotationComments about the goal
... outcomeCode 0..*CodeableConceptWhat result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (example): 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".


... outcomeReference 0..*Reference(Observation)Observation that resulted from goal

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Goal.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Goal.lifecycleStatusrequiredGoalLifecycleStatus
http://hl7.org/fhir/ValueSet/goal-status
from the FHIR Standard
Goal.achievementStatuspreferredGoalAchievementStatus
http://hl7.org/fhir/ValueSet/goal-achievement
from the FHIR Standard
Goal.categoryexampleGoalCategory
http://hl7.org/fhir/ValueSet/goal-category
from the FHIR Standard
Goal.prioritypreferredGoalPriority
http://hl7.org/fhir/ValueSet/goal-priority
from the FHIR Standard
Goal.descriptionextensibleUSCoreGoalCodes
http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description
Goal.start[x]preferredGoalStartEvent
http://hl7.org/fhir/ValueSet/goal-start-event
from the FHIR Standard
Goal.target.measureexampleLOINCCodes (a valid code from LOINC)
http://hl7.org/fhir/ValueSet/observation-codes
from the FHIR Standard
Goal.target.detail[x]example
Goal.outcomeCodeexampleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-2errorGoalIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorGoalIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorGoalIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorGoalIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceGoalA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
gol-1errorGoal.targetGoal.target.measure is required if Goal.target.detail is populated
: (detail.exists() and measure.exists()) or detail.exists().not()

This structure is derived from USCoreGoalProfile

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

 

Other representations of profile: CSV, Excel, Schematron