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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 IdGoal
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 DisplayDescribes the intended objective(s) for a patient, group or organization
Cardinality0..*
TypeDomainResource
Summaryfalse
Comments

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

Goal.identifier
Element IdGoal.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 DisplayExternal Ids for this goal
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

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

Summaryfalse
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 IdGoal.lifecycleStatus
Definition

The state of the goal throughout its lifecycle.

Short Displayproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Cardinality1..1
Terminology BindingGoalLifecycleStatus (Required)
Typecode
Is Modifiertrue (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.

Summarytrue
Comments

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

Goal.achievementStatus
Element IdGoal.achievementStatus
Definition

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

Short Displayin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Cardinality0..1
Terminology BindingGoalAchievementStatus (Preferred)
TypeCodeableConcept
Summarytrue
Goal.category
Element IdGoal.category
Definition

Indicates a category the goal falls within.

Short DisplayE.g. Treatment, dietary, behavioral, etc.
Cardinality0..*
Terminology BindingGoalCategory (Example)
TypeCodeableConcept
Requirements

Allows goals to be filtered and sorted.

Summarytrue
Goal.continuous
Element IdGoal.continuous
Definition

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

Short DisplayAfter meeting the goal, ongoing activity is needed to sustain the goal objective
Cardinality0..1
Typeboolean
Requirements

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

Summaryfalse
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 IdGoal.priority
Definition

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

Short Displayhigh-priority | medium-priority | low-priority
Cardinality0..1
Terminology BindingGoalPriority (Preferred)
TypeCodeableConcept
Requirements

Used for sorting and presenting goals.

Summarytrue
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 IdGoal.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 DisplayCode or text describing goal
Cardinality1..1
Terminology BindingSNOMED CT Clinical Findings (Example)
TypeCodeableConcept
Requirements

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

Summarytrue
Comments

If no code is available, use CodeableConcept.text.

Goal.subject
Element IdGoal.subject
Definition

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

Short DisplayWho this goal is intended for
Cardinality1..1
TypeReference(Patient | Group | Organization)
Requirements

Subject is optional to support annonymized reporting.

Summarytrue
Goal.start[x]
Element IdGoal.start[x]
Definition

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

Short DisplayWhen goal pursuit begins
Cardinality0..1
Terminology BindingGoalStartEvent (Example)
Typedate|CodeableConcept
[x] NoteSee 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.

Summarytrue
Goal.target
Element IdGoal.target
Definition

Indicates what should be done by when.

Short DisplayTarget outcome for the goal
Cardinality0..*
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.

Summaryfalse
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()
Affect this element
Goal.target.measure
Element IdGoal.target.measure
Definition

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

Short DisplayThe parameter whose value is being tracked
Cardinality0..1
Terminology BindingLOINC Codes (Example)
TypeCodeableConcept
Summarytrue
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 IdGoal.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.

Short DisplayThe target value to be achieved
Cardinality0..1
Terminology BindingGoalTargetDetail:
TypeQuantity|Range|CodeableConcept|string|boolean|integer|Ratio
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Summarytrue
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 IdGoal.target.due[x]
Definition

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

Short DisplayReach goal on or before
Cardinality0..1
Typedate|Duration
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Requirements

Identifies when the goal should be evaluated.

Summarytrue
Goal.statusDate
Element IdGoal.statusDate
Definition

Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc.

Short DisplayWhen goal status took effect
Cardinality0..1
Typedate
Summarytrue
Comments

To see the date for past statuses, query history.

Goal.statusReason
Element IdGoal.statusReason
Definition

Captures the reason for the current status.

Short DisplayReason for current status
Cardinality0..1
Typestring
Summaryfalse
Comments

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

Goal.source
Element IdGoal.source
Definition

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

Short DisplayWho's responsible for creating Goal?
Cardinality0..1
TypeReference(Patient | Practitioner | PractitionerRole | RelatedPerson | CareTeam)
Summarytrue
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 IdGoal.addresses
Definition

The identified conditions and other health record elements that are intended to be addressed by the goal.

Short DisplayIssues addressed by this goal
Cardinality0..*
TypeReference(Condition | Observation | MedicationUsage | MedicationRequest | NutritionOrder | ServiceRequest | RiskAssessment)
Requirements

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

Summaryfalse
Goal.note
Element IdGoal.note
Definition

Any comments related to the goal.

Short DisplayComments about the goal
Cardinality0..*
TypeAnnotation
Requirements

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

Summaryfalse
Comments

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

Goal.outcome
Element IdGoal.outcome
Definition

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

Short DisplayWhat result was achieved regarding the goal?
Cardinality0..*
Terminology BindingSNOMED CT Clinical Findings (Example)
TypeCodeableReference(Observation)
Requirements

Outcome tracking is a key aspect of care planning.

Summaryfalse
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.