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Patient Care icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Patient

Detailed Descriptions for the elements in the Goal resource.

Goal
Element Id Goal
Definition

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

Short Display Describes the intended objective(s) for a patient, group or organization
Cardinality 0..*
Type DomainResource
Summary false
Comments

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

Goal.identifier
Element Id Goal.identifier
Definition

Business identifiers assigned to this goal by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

Short Display External Ids for this goal
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
Requirements

Allows identification of the goal as it is known by various participating systems and in a way that remains consistent across servers.

Summary false
Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Goal.lifecycleStatus
Element Id Goal.lifecycleStatus
Definition

The state of the goal throughout its lifecycle.

Short Display proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Cardinality 1..1
Terminology Binding Goal Lifecycle Status (Required)
Type code
Is Modifier true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Requirements

Allows knowing whether goal needs to be further tracked.

Summary true
Comments

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

Goal.achievementStatus
Element Id Goal.achievementStatus
Definition

Describes the progression, or lack thereof, towards the goal against the target.

Short Display in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Cardinality 0..1
Terminology Binding Goal Achievement Status (Preferred)
Type CodeableConcept
Summary true
Goal.category
Element Id Goal.category
Definition

Indicates a category the goal falls within.

Short Display E.g. Treatment, dietary, behavioral, etc
Cardinality 0..*
Terminology Binding Goal Category (Example)
Type CodeableConcept
Requirements

Allows goals to be filtered and sorted.

Summary true
Goal.continuous
Element Id Goal.continuous
Definition

After meeting the goal, ongoing activity is needed to sustain the goal objective.

Short Display After meeting the goal, ongoing activity is needed to sustain the goal objective
Cardinality 0..1
Type boolean
Requirements

Allows for a system to programmatically update achievementStatus upon finding evidence the goal has been met.

Summary false
Comments

For example, getting a yellow fever vaccination for a planned trip is a goal that is designed to be completed (continuous = false). A goal to sustain HbA1c levels would not be a one-time goal (continuous = true).

Goal.priority
Element Id Goal.priority
Definition

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

Short Display high-priority | medium-priority | low-priority
Cardinality 0..1
Terminology Binding Goal Priority (Preferred)
Type CodeableConcept
Requirements

Used for sorting and presenting goals.

Summary true
Comments

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

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

Goal.description
Element Id Goal.description
Definition

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

Short Display Code or text describing goal
Cardinality 1..1
Terminology Binding Goal Description (Example)
Type CodeableConcept
Requirements

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

Summary true
Comments

If no code is available, use CodeableConcept.text.

Goal.subject
Element Id Goal.subject
Definition

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

Short Display Who this goal is intended for
Cardinality 1..1
Type Reference(Patient | Group | Organization)
Requirements

Subject is optional to support annonymized reporting.

Summary true
Goal.start[x]
Element Id Goal.start[x]
Definition

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

Short Display When goal pursuit begins
Cardinality 0..1
Terminology Binding Goal Start Event (Example)
Type date|CodeableConcept
[x] Note See Choice of Datatypes for further information about how to use [x]
Requirements

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

Summary true
Goal.acceptance
Element Id Goal.acceptance
Definition

Information about the acceptance and relative priority assigned to the goal by the patient, practitioners and other stakeholders.

Short Display Individual acceptance of goal
Cardinality 0..*
Summary false
Goal.acceptance.individual
Element Id Goal.acceptance.individual
Definition

The person whose acceptance/priority is being reflected.

Short Display Individual whose acceptance is reflected
Cardinality 1..1
Type Reference(Patient | Practitioner | RelatedPerson)
Summary false
Goal.acceptance.status
Element Id Goal.acceptance.status
Definition

Indicates whether the specified individual has accepted the goal or not.

Short Display agree | disagree | pending
Cardinality 0..1
Terminology Binding Goal acceptance status value set (Required)
Type code
Summary false
Goal.acceptance.priority
Element Id Goal.acceptance.priority
Definition

Indicates the relative priority assigned to the goal by the stakeholder.

Short Display Priority of goal for individual
Cardinality 0..1
Terminology Binding Goal Priority (Example)
Type CodeableConcept
Summary false
Goal.target
Element Id Goal.target
Definition

Indicates what should be done by when.

Short Display Target outcome for the goal
Cardinality 0..*
Requirements

Allows the progress of the goal to be monitored against an observation or due date. Target is 0..* to support Observations with multiple components, such as blood pressure goals with both a systolic and diastolic target.

Summary false
Comments

When multiple targets are present for a single goal instance, all targets must be met for the overall goal to be met.

Invariants
Defined on this element
gol-1Rule Goal.target.measure is required if Goal.target.detail is populated(detail.exists() and measure.exists()) or detail.exists().not()
Goal.target.measure
Element Id Goal.target.measure
Definition

The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

Short Display The parameter whose value is being tracked
Cardinality 0..1
Terminology Binding LOINC Codes (Example)
Type CodeableConcept
Summary true
Invariants
Affect this element
gol-1Rule Goal.target.measure is required if Goal.target.detail is populated(detail.exists() and measure.exists()) or detail.exists().not()
Goal.target.detail[x]
Element Id Goal.target.detail[x]
Definition

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. A CodeableConcept target value could be Positive, Negative, Abnormal, Normal, Present, Absent, Yes, No.

Short Display The target value to be achieved
Cardinality 0..1
Type Quantity|Range|CodeableConcept|string|boolean|integer|Ratio
[x] Note See Choice of Datatypes for further information about how to use [x]
Summary true
Comments

A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Goal.target.measure defines a coded value.

Invariants
Affect this element
gol-1Rule Goal.target.measure is required if Goal.target.detail is populated(detail.exists() and measure.exists()) or detail.exists().not()
Goal.target.due[x]
Element Id Goal.target.due[x]
Definition

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

Short Display Reach goal on or before
Cardinality 0..1
Type date|Duration
[x] Note See Choice of Datatypes for further information about how to use [x]
Requirements

Identifies when the goal should be evaluated.

Summary true
Goal.statusDate
Element Id Goal.statusDate
Definition

Identifies when the current achievement status took effect. I.e. When achieved, when improving, etc.

Short Display When goal achievment status took effect
Cardinality 0..1
Type date
Summary true
Comments

To see the date for past statuses, query history.

Goal.statusReason
Element Id Goal.statusReason
Definition

Captures the reason for the current lifecycle status.

Short Display Reason for current lifecycle status
Cardinality 0..*
Terminology Binding Goal Status Reason (Example)
Type CodeableConcept
Summary false
Comments

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

Goal.source
Element Id Goal.source
Definition

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

Short Display Who's responsible for creating Goal?
Cardinality 0..1
Type Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam)
Summary true
Comments

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

Goal.addresses
Element Id Goal.addresses
Definition

The identified conditions and other resources that provide the context for why the goal exists.

Short Display Issues addressed by this goal
Cardinality 0..*
Type Reference(Condition | Observation | MedicationStatement | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment | Procedure | NutritionIntake)
Requirements

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

Summary false
Goal.note
Element Id Goal.note
Definition

Any comments related to the goal.

Short Display Comments about the goal
Cardinality 0..*
Type Annotation
Requirements

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

Summary false
Comments

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

Goal.outcome
Element Id Goal.outcome
Definition

Identifies the change (or lack of change) at the point when the status of the goal is assessed.

Short Display What result was achieved regarding the goal?
Cardinality 0..*
Terminology Binding SNOMED CT Clinical Findings (Example)
Type CodeableReference(Observation)
Requirements

Outcome tracking is a key aspect of care planning.

Summary false
Comments

Note that this should not duplicate the goal status; 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.