PACIO Advance Healthcare Directive Interoperability Implementation Guide
2.0.0-ballot - STU 2 – Ballot

PACIO Advance Healthcare Directive Interoperability Implementation Guide, published by HL7 International / Patient Empowerment. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/pacio-adi/ and changes regularly. See the Directory of published versions

## Resource Profile: ADI Personal Goal

Official URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/ADI-PersonalGoal | Version: 2.0.0-ballot
Standards status: Trial-use | Maturity Level: 2 | Computable Name: ADIPersonalGoal

This profile is a statement that presents the author's personal health and treatment goals that are pertinent when planning their care.

The ADI PtAuthored Personal Goal represents the patient’s personal goals and values related to quality of life that are intended to inform the treatment being provided. This may be communicated as a statement of what is important to the patient to have a good quality of life, such as avoiding prolonged dependence on machines or being able to feed, bathe, and take care of themselves. They may want to be to be able to die at home or not be a financial burden to their family. Content creators or implementers may provide a list of things the patient can select that are personally important to them or the decisions may be captured in narrative form. Without any more specificity than what the personal goal of the patient is, a medical team may be able to narrow down a list of potential treatment interventions to just a few whose outcomes would enable meeting the patient’s documented personal goals and values.

Usages:

- Refer to this Profile: ADI PtAuthored Composition, ADI PMO Composition, ADI PMO Initial Treatment ServiceRequest, ADI Personal Priorities Organizer and ADI PtAuthored Care Plan
- Examples for this Profile: Goal/Example-Smith-Johnson-PersonalGoal1, Goal/Example-Smith-Johnson-PersonalGoal2 and Goal/Example-Smith-Johnson-PersonalGoal3
- CapabilityStatements using this Profile: ADI CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal | C | 0..* | USCoreGoalProfile | Describes the intended objective(s) for a patient, group or organization Constraints: goal-subject-expressedby
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
text | S | 1..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
lifecycleStatus | ?!S Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required)
Slices for category | S Σ | 1..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Slice: Unordered, Open by value:$this Binding: GoalCategory (example): Codes for grouping and sorting goals.
category:All Slices |  |  |  | Content/Rules for all slices
text | S Σ | 0..1 | string | Plain text representation of the concept
category:type | S Σ | 1..1 | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Binding: Health Goals Grouping (required)
text | S Σ | 0..1 | string | Plain text representation of the concept
description | S Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: US Core Goal Codes (preferred): Value set to describe the Goal
Additional Bindings | Purpose
Social Determinants of Health Goals | Preferred
Slices for extension |  |  |  | Content/Rules for all slices
extension:EnclosedPreconditionExtension |  | 0..1 | CodeableConcept | Enclosed Precondition URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-enclosedPrecondition-extension
subject | S Σ | 1..1 | Reference(US Core Patient Profile S) | Who this goal is intended for
start[x] | S Σ | 0..1 |  | When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate |  |  | date S |
startCodeableConcept |  |  | CodeableConcept |
target | S C | 0..* | BackboneElement | Target outcome for the goal Constraints: gol-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
due[x] | S Σ | 0..1 |  | Reach goal on or before
dueDate |  |  | date S |
dueDuration |  |  | Duration |
expressedBy | S Σ | 1..1 | Reference(US Core Patient Profile) | Who's responsible for creating Goal?
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Goal.lifecycleStatus | required | GoalLifecycleStatus `http://hl7.org/fhir/ValueSet/goal-status` From the FHIR Standard
Goal.category | example | GoalCategory `http://hl7.org/fhir/ValueSet/goal-category` From the FHIR Standard
Goal.category:type | required | HealthGoalsGrouping `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.7` From https://vsac.nlm.nih.gov
Goal.description | preferred | USCoreGoalCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description`
Goal.start[x] | example | GoalStartEvent `http://hl7.org/fhir/ValueSet/goal-start-event` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Goal | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Goal | If 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-4 | error | Goal | If 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-5 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Goal | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
goal-subject-expressedby | error | Goal | subject and expressedBy refer to the same patient : subject = expressedBy |
gol-1 | error | Goal.target | Goal.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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal | C | 0..* | USCoreGoalProfile | Describes the intended objective(s) for a patient, group or organization Constraints: goal-subject-expressedby
text | S | 1..1 | Narrative | Text summary of the resource, for human interpretation
Slices for category | S | 1..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Slice: Unordered, Open by value:$this
category:All Slices |  |  |  | Content/Rules for all slices
text | S | 0..1 | string | Plain text representation of the concept
category:type | S | 1..1 | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Binding: Health Goals Grouping (required)
description |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:EnclosedPreconditionExtension |  | 0..1 | CodeableConcept | Enclosed Precondition URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-enclosedPrecondition-extension
subject |  | 1..1 | Reference(US Core Patient Profile) | Who this goal is intended for
expressedBy |  | 1..1 | Reference(US Core Patient Profile) | Who's responsible for creating Goal?
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Goal.category:type | required | HealthGoalsGrouping `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.7` From https://vsac.nlm.nih.gov

#### Constraints

Id | Grade | Path(s) | Details | Requirements
goal-subject-expressedby | error | Goal | subject and expressedBy refer to the same patient : subject = expressedBy |

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal | C | 0..* | USCoreGoalProfile | Describes the intended objective(s) for a patient, group or organization Constraints: goal-subject-expressedby
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text | S | 1..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External Ids for this goal
lifecycleStatus | ?!S Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required)
achievementStatus | Σ | 0..1 | CodeableConcept | in-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.
Slices for category | S Σ | 1..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Slice: Unordered, Open by value:$this Binding: GoalCategory (example): Codes for grouping and sorting goals.
category:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
category:type | S Σ | 1..1 | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Binding: Health Goals Grouping (required)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
priority | Σ | 0..1 | CodeableConcept | high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal.
description | S Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: US Core Goal Codes (preferred): Value set to describe the Goal
Additional Bindings | Purpose
Social Determinants of Health Goals | Preferred
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:EnclosedPreconditionExtension |  | 0..1 | CodeableConcept | Enclosed Precondition URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-enclosedPrecondition-extension
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile S) | Who this goal is intended for
start[x] | S Σ | 0..1 |  | When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate |  |  | date S |
startCodeableConcept |  |  | CodeableConcept |
target | S C | 0..* | BackboneElement | Target outcome for the goal Constraints: gol-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
measure | Σ C | 0..1 | CodeableConcept | The 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] | Σ C | 0..1 |  | The target value to be achieved Binding Description: (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.
detailQuantity |  |  | Quantity |
detailRange |  |  | Range |
detailCodeableConcept |  |  | CodeableConcept |
detailString |  |  | string |
detailBoolean |  |  | boolean |
detailInteger |  |  | integer |
detailRatio |  |  | Ratio |
due[x] | S Σ | 0..1 |  | Reach goal on or before
dueDate |  |  | date S |
dueDuration |  |  | Duration |
statusDate | Σ | 0..1 | date | When goal status took effect
statusReason |  | 0..1 | string | Reason for current status
expressedBy | S Σ | 1..1 | Reference(US Core Patient Profile) | 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? 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
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Goal.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Goal.lifecycleStatus | required | GoalLifecycleStatus `http://hl7.org/fhir/ValueSet/goal-status` From the FHIR Standard
Goal.achievementStatus | preferred | GoalAchievementStatus `http://hl7.org/fhir/ValueSet/goal-achievement` From the FHIR Standard
Goal.category | example | GoalCategory `http://hl7.org/fhir/ValueSet/goal-category` From the FHIR Standard
Goal.category:type | required | HealthGoalsGrouping `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.7` From https://vsac.nlm.nih.gov
Goal.priority | preferred | GoalPriority `http://hl7.org/fhir/ValueSet/goal-priority` From the FHIR Standard
Goal.description | preferred | USCoreGoalCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description`
Goal.start[x] | example | GoalStartEvent `http://hl7.org/fhir/ValueSet/goal-start-event` From the FHIR Standard
Goal.target.measure | example | LOINCCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` From the FHIR Standard
Goal.target.detail[x] | example |
Goal.outcomeCode | example | SNOMEDCTClinicalFindings `http://hl7.org/fhir/ValueSet/clinical-findings` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Goal | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Goal | If 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-4 | error | Goal | If 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-5 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Goal | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
goal-subject-expressedby | error | Goal | subject and expressedBy refer to the same patient : subject = expressedBy |
gol-1 | error | Goal.target | Goal.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: 4 elements
Must-Support: 4 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-enclosedPrecondition-extension

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Goal.category

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal | C | 0..* | USCoreGoalProfile | Describes the intended objective(s) for a patient, group or organization Constraints: goal-subject-expressedby
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
text | S | 1..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
lifecycleStatus | ?!S Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required)
Slices for category | S Σ | 1..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Slice: Unordered, Open by value:$this Binding: GoalCategory (example): Codes for grouping and sorting goals.
category:All Slices |  |  |  | Content/Rules for all slices
text | S Σ | 0..1 | string | Plain text representation of the concept
category:type | S Σ | 1..1 | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Binding: Health Goals Grouping (required)
text | S Σ | 0..1 | string | Plain text representation of the concept
description | S Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: US Core Goal Codes (preferred): Value set to describe the Goal
Additional Bindings | Purpose
Social Determinants of Health Goals | Preferred
Slices for extension |  |  |  | Content/Rules for all slices
extension:EnclosedPreconditionExtension |  | 0..1 | CodeableConcept | Enclosed Precondition URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-enclosedPrecondition-extension
subject | S Σ | 1..1 | Reference(US Core Patient Profile S) | Who this goal is intended for
start[x] | S Σ | 0..1 |  | When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate |  |  | date S |
startCodeableConcept |  |  | CodeableConcept |
target | S C | 0..* | BackboneElement | Target outcome for the goal Constraints: gol-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
due[x] | S Σ | 0..1 |  | Reach goal on or before
dueDate |  |  | date S |
dueDuration |  |  | Duration |
expressedBy | S Σ | 1..1 | Reference(US Core Patient Profile) | Who's responsible for creating Goal?
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Goal.lifecycleStatus | required | GoalLifecycleStatus `http://hl7.org/fhir/ValueSet/goal-status` From the FHIR Standard
Goal.category | example | GoalCategory `http://hl7.org/fhir/ValueSet/goal-category` From the FHIR Standard
Goal.category:type | required | HealthGoalsGrouping `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.7` From https://vsac.nlm.nih.gov
Goal.description | preferred | USCoreGoalCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description`
Goal.start[x] | example | GoalStartEvent `http://hl7.org/fhir/ValueSet/goal-start-event` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Goal | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Goal | If 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-4 | error | Goal | If 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-5 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Goal | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
goal-subject-expressedby | error | Goal | subject and expressedBy refer to the same patient : subject = expressedBy |
gol-1 | error | Goal.target | Goal.target.measure is required if Goal.target.detail is populated : (detail.exists() and measure.exists()) or detail.exists().not() |

Differential View

This structure is derived from USCoreGoalProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal | C | 0..* | USCoreGoalProfile | Describes the intended objective(s) for a patient, group or organization Constraints: goal-subject-expressedby
text | S | 1..1 | Narrative | Text summary of the resource, for human interpretation
Slices for category | S | 1..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Slice: Unordered, Open by value:$this
category:All Slices |  |  |  | Content/Rules for all slices
text | S | 0..1 | string | Plain text representation of the concept
category:type | S | 1..1 | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Binding: Health Goals Grouping (required)
description |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:EnclosedPreconditionExtension |  | 0..1 | CodeableConcept | Enclosed Precondition URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-enclosedPrecondition-extension
subject |  | 1..1 | Reference(US Core Patient Profile) | Who this goal is intended for
expressedBy |  | 1..1 | Reference(US Core Patient Profile) | Who's responsible for creating Goal?
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Goal.category:type | required | HealthGoalsGrouping `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.7` From https://vsac.nlm.nih.gov

#### Constraints

Id | Grade | Path(s) | Details | Requirements
goal-subject-expressedby | error | Goal | subject and expressedBy refer to the same patient : subject = expressedBy |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal | C | 0..* | USCoreGoalProfile | Describes the intended objective(s) for a patient, group or organization Constraints: goal-subject-expressedby
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text | S | 1..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | External Ids for this goal
lifecycleStatus | ?!S Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required)
achievementStatus | Σ | 0..1 | CodeableConcept | in-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.
Slices for category | S Σ | 1..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Slice: Unordered, Open by value:$this Binding: GoalCategory (example): Codes for grouping and sorting goals.
category:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
category:type | S Σ | 1..1 | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Binding: Health Goals Grouping (required)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | S Σ | 0..1 | string | Plain text representation of the concept
priority | Σ | 0..1 | CodeableConcept | high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal.
description | S Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: US Core Goal Codes (preferred): Value set to describe the Goal
Additional Bindings | Purpose
Social Determinants of Health Goals | Preferred
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:EnclosedPreconditionExtension |  | 0..1 | CodeableConcept | Enclosed Precondition URL: http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-enclosedPrecondition-extension
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile S) | Who this goal is intended for
start[x] | S Σ | 0..1 |  | When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate |  |  | date S |
startCodeableConcept |  |  | CodeableConcept |
target | S C | 0..* | BackboneElement | Target outcome for the goal Constraints: gol-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
measure | Σ C | 0..1 | CodeableConcept | The 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] | Σ C | 0..1 |  | The target value to be achieved Binding Description: (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.
detailQuantity |  |  | Quantity |
detailRange |  |  | Range |
detailCodeableConcept |  |  | CodeableConcept |
detailString |  |  | string |
detailBoolean |  |  | boolean |
detailInteger |  |  | integer |
detailRatio |  |  | Ratio |
due[x] | S Σ | 0..1 |  | Reach goal on or before
dueDate |  |  | date S |
dueDuration |  |  | Duration |
statusDate | Σ | 0..1 | date | When goal status took effect
statusReason |  | 0..1 | string | Reason for current status
expressedBy | S Σ | 1..1 | Reference(US Core Patient Profile) | 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? 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
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Goal.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
Goal.lifecycleStatus | required | GoalLifecycleStatus `http://hl7.org/fhir/ValueSet/goal-status` From the FHIR Standard
Goal.achievementStatus | preferred | GoalAchievementStatus `http://hl7.org/fhir/ValueSet/goal-achievement` From the FHIR Standard
Goal.category | example | GoalCategory `http://hl7.org/fhir/ValueSet/goal-category` From the FHIR Standard
Goal.category:type | required | HealthGoalsGrouping `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1115.7` From https://vsac.nlm.nih.gov
Goal.priority | preferred | GoalPriority `http://hl7.org/fhir/ValueSet/goal-priority` From the FHIR Standard
Goal.description | preferred | USCoreGoalCodes `http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description`
Goal.start[x] | example | GoalStartEvent `http://hl7.org/fhir/ValueSet/goal-start-event` From the FHIR Standard
Goal.target.measure | example | LOINCCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` From the FHIR Standard
Goal.target.detail[x] | example |
Goal.outcomeCode | example | SNOMEDCTClinicalFindings `http://hl7.org/fhir/ValueSet/clinical-findings` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Goal | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Goal | If 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-4 | error | Goal | If 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-5 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Goal | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
goal-subject-expressedby | error | Goal | subject and expressedBy refer to the same patient : subject = expressedBy |
gol-1 | error | Goal.target | Goal.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: 4 elements
Must-Support: 4 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/pacio-adi/StructureDefinition/adi-enclosedPrecondition-extension

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Goal.category

Maturity: 2

Other representations of profile: CSV, Excel, Schematron