ACP-MedicalPolicyGoal
type: StructureDefinition
node role: treeRoot
id:
  v: ACP-MedicalPolicyGoal
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition ACP-MedicalPolicyGoal Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Goal 0..* Goal Describes the intended objective(s) for a patient, group or organization #xD; category 1..* CodeableConcept E.g. Treatment, dietary, behavioral, etc. Required Pattern: At least the following #xD; coding 1..* Coding Code defined by a terminology system Fixed Value: (Complex) #xD; system 1..1 uri Identity of the terminology system Fixed Value: http://snomed.info/sct #xD; code 1..1 code Symbol in syntax defined by the system Fixed Value: 713603004 #xD; description 1..1 CodeableConcept Code or text describing goal Binding: MedicalPolicyGoalVS (1.0.0-rc1) (required) #xD; subject 0..1 Reference(ACP Patient(1.0.0-rc1)) Who this goal is intended for #xD; Slices for start[x] 0..1 date, CodeableConcept When goal pursuit begins Slice: Unordered, Open by type:$this #xD; start[x]:startDate 0..1 date When goal pursuit begins #xD; note #xD; text 1..1 string The annotation - text content #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
url:
  v: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACPMedicalPolicyGoal
  l: ACPMedicalPolicyGoal
version:
  v: 1.0.0-rc1
name:
  v: ACPMedicalPolicyGoal
title:
  v: ACP Medical Policy Goal
status:
  v: draft
experimental:
  v: false
date:
  v: 2026-02-17T10:29:38+00:00
publisher:
  v: IKNL
contact:
  telecom:
    system:
      v: url
    value:
      v: https://www.iknl.nl
description:
  v: The primary, agreed-upon goal of a patient's medical treatment policy. Based on Goal resource.
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
      l: m49.htm
    code:
      v: 001
copyright:
  v: Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.
fhir version:
  v: 3.0.2
mapping:
  identity:
    v: pall-izppz-zib2017v2025-03-11
  uri:
    v: https://decor.nictiz.nl/exist/apps/api/dataset/2.16.840.1.113883.2.4.3.11.60.117.1.1/2020-07-29T10%3A37%3A48/$view
    l: https://decor.nictiz.nl/exist/apps/api/dataset/2.16.840.1.113883.2.4.3.11.60.117.1.1/2020-07-29T10%3A37%3A48/$view
  name:
    v: ACP zib2017 dataset
kind:
  v: resource
abstract:
  v: false
type:
  v: Goal
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Goal
  l: Goal
derivation:
  v: constraint
snapshot:
  element:
    id:
      v: Goal
    path:
      v: Goal
    short:
      v: Describes the intended objective(s) for a patient, group or organization
    definition:
      v: 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.
    comment:
      v: Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline.
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Goal
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-1
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain any narrative
      expression:
        v: contained.text.empty()
      xpath:
        v: not(parent::f:contained and f:text)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-4
      severity:
        v: error
      human:
        v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
      expression:
        v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
      xpath:
        v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-3
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
      expression:
        v: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
      xpath:
        v: not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    mapping:
      identity:
        v: pall-izppz-zib2017v2025-03-11
      map:
        v: 157
      comment:
        v: Belangrijkste doel van behandeling (AlgemeneMeting)
    mapping:
      identity:
        v: pall-izppz-zib2017v2025-03-11
      map:
        v: 162
      comment:
        v: MetingNaam voor Belangrijkste doel van behandeling
    mapping:
      identity:
        v: rim
      map:
        v: Entity. Role, or Act
    mapping:
      identity:
        v: v2
      map:
        v: GOL.1
    mapping:
      identity:
        v: rim
      map:
        v: .outboundRelationship[typeCode<=OBJ].
    mapping:
      identity:
        v: w5
      map:
        v: clinical.careprovision
  element:
    id:
      v: Goal.id
    path:
      v: Goal.id
    short:
      v: Logical id of this artifact
    definition:
      v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
    comment:
      v: The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: Resource.id
      min:
        v: 0
      max:
        v: 1
    type:
      code:
        v: id
        l: id

v: true

id:
  v: Goal.meta
path:
  v: Goal.meta
short:
  v: Metadata about the resource
definition:
  v: The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
    l: Meta
is summary:
  v: true

id:
  v: Goal.implicitRules
path:
  v: Goal.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
comment:
  v: Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
is modifier:
  v: true
is summary:
  v: true

id:
  v: Goal.language
path:
  v: Goal.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
      l: elementdefinition-maxValueSet
    value: Reference
      l: 3.0
      l: .2
      reference:
        v: http://hl7.org/fhir/ValueSet/all-languages|3.0.2
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: extensible
  description:
    v: A human language.
  value set: Reference
    l: 3.0
    l: .2
    reference:
      v: http://hl7.org/fhir/ValueSet/languages|3.0.2

id:
  v: Goal.text
path:
  v: Goal.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
comment:
  v: Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
    l: Narrative
condition:
  v: dom-1
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: Goal.contained
path:
  v: Goal.contained
short:
  v: Contained, inline Resources
definition:
  v: These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
comment:
  v: This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
    l: Resource
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Goal.extension
path:
  v: Goal.extension
short:
  v: Additional Content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Goal.modifierExtension
path:
  v: Goal.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
is modifier:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Goal.identifier
path:
  v: Goal.identifier
short:
  v: External Ids for this goal
definition:
  v: 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).
requirements:
  v: Need to allow connection to a wider workflow.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Goal.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
mapping:
  identity:
    v: rim
  map:
    v: .id
mapping:
  identity:
    v: w5
  map:
    v: id

id:
  v: Goal.status
path:
  v: Goal.status
short:
  v: proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected
definition:
  v: Indicates whether the goal has been reached and is still considered relevant.
comment:
  v: This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
requirements:
  v: Allows measuring outcome and whether goal needs to be further tracked.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Goal.status
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
is modifier:
  v: true
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: GoalStatus
  strength:
    v: required
  description:
    v: Indicates whether the goal has been met and is still being targeted
  value set: Reference
    l: 3.0
    l: .2
    reference:
      v: http://hl7.org/fhir/ValueSet/goal-status|3.0.2
mapping:
  identity:
    v: v2
  map:
    v: GOL-18-goal life cycle status
mapping:
  identity:
    v: rim
  map:
    v: .statusCode in-progress = active (classCode = OBJ) achieved = complete sustaining = active (classCode=OBJC) cancelled = aborted
mapping:
  identity:
    v: w5
  map:
    v: status

id:
  v: Goal.category
path:
  v: Goal.category
short:
  v: E.g. Treatment, dietary, behavioral, etc.
definition:
  v: Indicates a category the goal falls within.
requirements:
  v: Allows goals to be filtered and sorted.
min:
  v: 1
max:
  v: *
base:
  path:
    v: Goal.category
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
pattern: CodeableConcept
  coding: http://snomed.info/id/713603004
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 713603004
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: GoalCategory
  strength:
    v: example
  description:
    v: Codes for grouping and sorting goals
  value set: Reference
    l: 3.0
    l: .2
    reference:
      v: http://hl7.org/fhir/ValueSet/goal-category|3.0.2
mapping:
  identity:
    v: w5
  map:
    v: class

id:
  v: Goal.priority
path:
  v: Goal.priority
short:
  v: high-priority | medium-priority | low-priority
definition:
  v: Identifies the mutually agreed level of importance associated with reaching/sustaining the goal.
comment:
  v: 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".
requirements:
  v: Used for sorting and presenting goals.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.priority
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: GoalPriority
  strength:
    v: preferred
  description:
    v: The level of importance associated with a goal
  value set: Reference
    l: 3.0
    l: .2
    reference:
      v: http://hl7.org/fhir/ValueSet/goal-priority|3.0.2
mapping:
  identity:
    v: rim
  map:
    v: .priorityCode
mapping:
  identity:
    v: w5
  map:
    v: grade

id:
  v: Goal.description
path:
  v: Goal.description
short:
  v: Code or text describing goal
definition:
  v: 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".
comment:
  v: If no code is available, use CodeableConcept.text.
requirements:
  v: Without a description of what's trying to be achieved, element has no purpose.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Goal.description
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
is summary:
  v: true
binding:
  strength:
    v: required
  value set: Reference
    l: 1.0
    l: .0
    reference:
      v: https://api.iknl.nl/docs/pzp/stu3/ValueSet/ACP-MedicalPolicyGoal|1.0.0-rc1
mapping:
  identity:
    v: pall-izppz-zib2017v2025-03-11
  map:
    v: 163
  comment:
    v: Doel (UitslagWaarde)
mapping:
  identity:
    v: v2
  map:
    v: GOL-3.2-goal ID.text
mapping:
  identity:
    v: rim
  map:
    v: .text
mapping:
  identity:
    v: w5
  map:
    v: what

id:
  v: Goal.subject
path:
  v: Goal.subject
short:
  v: Who this goal is intended for
definition:
  v: Identifies the patient, group or organization for whom the goal is being established.
requirements:
  v: Subject is optional to support annonymized reporting.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.subject
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-Patient|1.0.0-rc1
    l: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-Patient
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: PID-3-patient ID list
mapping:
  identity:
    v: rim
  map:
    v: .participation[typeCode=PAT].role[classCode=PAT]
mapping:
  identity:
    v: w5
  map:
    v: who.focus

id:
  v: Goal.start[x]
path:
  v: Goal.start[x]
slicing:
  discriminator:
    type:
      v: type
    path:
      v: $this
  ordered:
    v: false
  rules:
    v: open
short:
  v: When goal pursuit begins
definition:
  v: The date or event after which the goal should begin being pursued.
requirements:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.start[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: GoalStartEvent
  strength:
    v: example
  description:
    v: Codes describing events that can trigger the initiation of a goal
  value set: Reference
    l: 3.0
    l: .2
    reference:
      v: http://hl7.org/fhir/ValueSet/goal-start-event|3.0.2
mapping:
  identity:
    v: w5
  map:
    v: when.planned

id:
  v: Goal.start[x]:startDate
path:
  v: Goal.start[x]
slice name:
  v: startDate
short:
  v: When goal pursuit begins
definition:
  v: The date or event after which the goal should begin being pursued.
requirements:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.start[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
is summary:
  v: true
mapping:
  identity:
    v: pall-izppz-zib2017v2025-03-11
  map:
    v: 165
  comment:
    v: UitslagDatumTijd
mapping:
  identity:
    v: w5
  map:
    v: when.planned

id:
  v: Goal.target
path:
  v: Goal.target
short:
  v: Target outcome for the goal
definition:
  v: Indicates what should be done by when.
requirements:
  v: Allows the progress of the goal to be monitored against an observation or due date.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.target
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: BackboneElement
    l: BackboneElement
condition:
  v: gol-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() | (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: gol-1
  severity:
    v: error
  human:
    v: Goal.target.measure is required if Goal.target.detail is populated
  expression:
    v: (detail.exists() and measure.exists()) or detail.exists().not()
  xpath:
    v: (exists(f:*[starts-with(local-name(.), 'detail')]) and exists(f:measure)) or not(exists(f:*[starts-with(local-name(.), 'detail')]))
  source:
    v: http://hl7.org/fhir/StructureDefinition/Goal
    l: Goal

id:
  v: Goal.target.id
path:
  v: Goal.target.id
representation:
  v: xmlAttr
short:
  v: xml:id (or equivalent in JSON)
definition:
  v: unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Goal.target.extension
path:
  v: Goal.target.extension
short:
  v: Additional Content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Goal.target.modifierExtension
path:
  v: Goal.target.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
is modifier:
  v: true
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Goal.target.measure
path:
  v: Goal.target.measure
short:
  v: The parameter whose value is being tracked
definition:
  v: The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.target.measure
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
condition:
  v: gol-1
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: GoalTargetMeasure
  strength:
    v: example
  description:
    v: Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
  value set: Reference
    l: 3.0
    l: .2
    reference:
      v: http://hl7.org/fhir/ValueSet/observation-codes|3.0.2

id:
  v: Goal.target.detail[x]
path:
  v: Goal.target.detail[x]
short:
  v: The target value to be achieved
definition:
  v: 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.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.target.detail[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Quantity
    l: Quantity
type:
  code:
    v: Range
    l: Range
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
condition:
  v: gol-1
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: GoalTargetDetail
  strength:
    v: example
  description:
    v: Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.

id:
  v: Goal.target.due[x]
path:
  v: Goal.target.due[x]
short:
  v: Reach goal on or before
definition:
  v: Indicates either the date or the duration after start by which the goal should be met.
requirements:
  v: Identifies when the goal should be evaluated.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.target.due[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
type:
  code:
    v: Duration
    l: Duration
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: when.done

id:
  v: Goal.statusDate
path:
  v: Goal.statusDate
short:
  v: When goal status took effect
definition:
  v: Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc.
comment:
  v: To see the date for past statuses, query history.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.statusDate
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: when.recorded

id:
  v: Goal.statusReason
path:
  v: Goal.statusReason
short:
  v: Reason for current status
definition:
  v: Captures the reason for the current status.
comment:
  v: This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.statusReason
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string

id:
  v: Goal.expressedBy
path:
  v: Goal.expressedBy
short:
  v: Who's responsible for creating Goal?
definition:
  v: Indicates whose goal this is - patient goal, practitioner goal, etc.
comment:
  v: This is the individual reponsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Goal.expressedBy
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Patient
    l: Patient
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner
    l: Practitioner
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/RelatedPerson
    l: RelatedPerson
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: who.source

id:
  v: Goal.addresses
path:
  v: Goal.addresses
short:
  v: Issues addressed by this goal
definition:
  v: The identified conditions and other health record elements that are intended to be addressed by the goal.
requirements:
  v: Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Goal.addresses
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Condition
    l: Condition
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Observation
    l: Observation
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/MedicationStatement
    l: MedicationStatement
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/NutritionOrder
    l: NutritionOrder
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/ProcedureRequest
    l: ProcedureRequest
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/RiskAssessment
    l: RiskAssessment
mapping:
  identity:
    v: rim
  map:
    v: .outboundRelationship[typeCode=SUBJ].target[classCode=CONC]
mapping:
  identity:
    v: w5
  map:
    v: why

id:
  v: Goal.note
path:
  v: Goal.note
short:
  v: Comments about the goal
definition:
  v: Any comments related to the goal.
comment:
  v: May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.
requirements:
  v: There's a need to capture information about the goal that doesn't actually describe the goal.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Goal.note
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Annotation
    l: Annotation
mapping:
  identity:
    v: v2
  map:
    v: GOL-16-goal evaluation + NTE?
mapping:
  identity:
    v: rim
  map:
    v: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

id:
  v: Goal.note.id
path:
  v: Goal.note.id
representation:
  v: xmlAttr
short:
  v: xml:id (or equivalent in JSON)
definition:
  v: unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Goal.note.extension
path:
  v: Goal.note.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional Content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
comment:
  v: There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Goal.note.author[x]
path:
  v: Goal.note.author[x]
short:
  v: Individual responsible for the annotation
definition:
  v: The individual responsible for making the annotation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Annotation.author[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner
    l: Practitioner
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Patient
    l: Patient
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/RelatedPerson
    l: RelatedPerson
type:
  code:
    v: string
    l: string
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: N/A
mapping:
  identity:
    v: rim
  map:
    v: Act.participant[typeCode=AUT].role

id:
  v: Goal.note.time
path:
  v: Goal.note.time
short:
  v: When the annotation was made
definition:
  v: Indicates when this particular annotation was made.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Annotation.time
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime
is summary:
  v: true
mapping:
  identity:
    v: v2
  map:
    v: N/A
mapping:
  identity:
    v: rim
  map:
    v: Act.effectiveTime

id:
  v: Goal.note.text
path:
  v: Goal.note.text
short:
  v: The annotation - text content
definition:
  v: The text of the annotation.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Annotation.text
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: string
    l: string
mapping:
  identity:
    v: pall-izppz-zib2017v2025-03-11
  map:
    v: 160
  comment:
    v: Toelichting
mapping:
  identity:
    v: v2
  map:
    v: N/A
mapping:
  identity:
    v: rim
  map:
    v: Act.text

id:
  v: Goal.outcomeCode
path:
  v: Goal.outcomeCode
short:
  v: What result was achieved regarding the goal?
definition:
  v: Identifies the change (or lack of change) at the point when the status of the goal is assessed.
comment:
  v: Note that this should not duplicate the goal status.
requirements:
  v: Outcome tracking is a key aspect of care planning.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Goal.outcomeCode
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: GoalOutcome
  strength:
    v: example
  description:
    v: 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"
  value set: Reference
    l: 3.0
    l: .2
    reference:
      v: http://hl7.org/fhir/ValueSet/clinical-findings|3.0.2

id:
  v: Goal.outcomeReference
path:
  v: Goal.outcomeReference
short:
  v: Observation that resulted from goal
definition:
  v: Details of what's changed (or not changed).
comment:
  v: The goal outcome is independent of the outcome of the related activities. For example, if the Goal is to 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.
requirements:
  v: Outcome tracking is a key aspect of care planning.
min:
  v: 0
max:
  v: *
base:
  path:
    v: Goal.outcomeReference
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Observation
    l: Observation

element:
  id:
    v: Goal
  path:
    v: Goal
  mapping:
    identity:
      v: pall-izppz-zib2017v2025-03-11
    map:
      v: 157
    comment:
      v: Belangrijkste doel van behandeling (AlgemeneMeting)
  mapping:
    identity:
      v: pall-izppz-zib2017v2025-03-11
    map:
      v: 162
    comment:
      v: MetingNaam voor Belangrijkste doel van behandeling
element:
  id:
    v: Goal.category
  path:
    v: Goal.category
  min:
    v: 1
  pattern: CodeableConcept
    coding: http://snomed.info/id/713603004
      system:
        v: http://snomed.info/sct
        l: sct
      code:
        v: 713603004
element:
  id:
    v: Goal.description
  path:
    v: Goal.description
  binding:
    strength:
      v: required
    value set: Reference
      l: 1.0
      l: .0
      reference:
        v: https://api.iknl.nl/docs/pzp/stu3/ValueSet/ACP-MedicalPolicyGoal|1.0.0-rc1
  mapping:
    identity:
      v: pall-izppz-zib2017v2025-03-11
    map:
      v: 163
    comment:
      v: Doel (UitslagWaarde)
element:
  id:
    v: Goal.subject
  path:
    v: Goal.subject
  type:
    code:
      v: Reference
      l: Reference
    target profile:
      v: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-Patient|1.0.0-rc1
      l: https://api.iknl.nl/docs/pzp/stu3/StructureDefinition/ACP-Patient
element:
  id:
    v: Goal.start[x]
  path:
    v: Goal.start[x]
  slicing:
    discriminator:
      type:
        v: type
      path:
        v: $this
    ordered:
      v: false
    rules:
      v: open
element:
  id:
    v: Goal.start[x]:startDate
  path:
    v: Goal.start[x]
  slice name:
    v: startDate
  type:
    code:
      v: date
      l: date
  mapping:
    identity:
      v: pall-izppz-zib2017v2025-03-11
    map:
      v: 165
    comment:
      v: UitslagDatumTijd
element:
  id:
    v: Goal.note.text
  path:
    v: Goal.note.text
  mapping:
    identity:
      v: pall-izppz-zib2017v2025-03-11
    map:
      v: 160
    comment:
      v: Toelichting