Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON

Logical Model: Goal Observation

This template represents a patient health goal. A Goal Observation template may have related components that are acts, encounters, observations, procedures, substance administrations, or supplies. A goal identifies a future desired condition or state. Goals are often related to physical or mental health conditions or diseases, but also may be related to a Social Determinant of Health (SDOH) risks or states. For example, to have adequate quality meals and snacks, gain transportation security - able to access health and social needs). SDOH data relate to conditions in which people live, learn, work, and play and their effects on health risks and outcomes. A Goal is established by the patient or provider or both.

A goal may be a patient or provider goal. If the author is set to the recordTarget (patient), this is a patient goal. If the author is set to a provider, this is a provider goal. If both patient and provider are set as authors, this is called a negotiated or shared goal.

A goal usually has a related health concern and/or risk.

A goal may have components consisting of other goals (milestones). These milestones are related to the overall goal through entryRelationships.

Usage:

• Use this Logical Model: Goal Observation, Goals Section and Plan of Treatment Section

Formal Views of Template Content

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

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

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:goal-obs		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.121
@extension		1..1	st	Required Pattern: 2022-06-01
@classCode		1..1	cs	Fixed Value: OBS
@moodCode		1..1	cs	Fixed Value: GOL
id		1..*	II
code		1..1	CD	When the Goal is Social Determinant of Health Goal, the observation/code SHOULD contain exactly one [1..1] code, which SHOULD contain exactly one [1..1] @code="8689-2 "History of Social function
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS
@nullFlavor		0..0
@code		1..1	cs	Binding: ActStatus (required)
effectiveTime		0..1	IVL_TS	effectiveTime/low represents when to start working on the goal. effectiveTime/high or effectiveTime/value represents when the goal should be met (i.e. a due date)
Slices for value		0..1	ANY, BL, ED, ST, CD, CV, CE, CO, SC, II, TEL, AD, EN, INT, REAL, PQ, MO, TS, IVL_PQ, IVL_TS, PIVL_TS, EIVL_TS, SXPR_TS, RTO_PQ_PQ	Slice: Unordered, Open by type:$this
value:coded		0..1	CD	Binding: (unbound) (example): See additional binding Additional Bindings Purpose Documentation Social Determinants of Health Goals Preferred Binding Social Determinant of Health Goals
author		0..*	AuthorParticipation	If the author is the recordTarget (patient), this is a patient goal. If the author is a provider, this is a provider goal. If both patient and provider are authors, this is a negotiated goal. If no author is present, it is assumed the document or section author(s) is the author of this goal.
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, value:typeCode
entryRelationship:refersTo		0..*	EntryRelationship	The following entryRelationship represents the relationship between a Goal Observation and another entry (usually a Health Concern Act) (Goal Observation REFERS TO Health Concern Act) already described in the CDA document instance. Rather than clone the whole entry, an Entry Reference may be used in this entryRelationship to reference this entry.
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	EntryReference	Base for all types and resources
entryRelationship:componentEntry		0..*	EntryRelationship	The following entryRelationship represents a planned component of the goal such as Planned Encounter (V2), Planned Procedure (V2), Planned Medication Activity (V2), Planned Supply (V2), Planned Act (V2) or Planned Immunization Activity. Because these entries are already described in the Interventions Section of the CDA document instance, rather than repeating the full content of the entries, the Entry Reference template may be used to reference the entries.
@typeCode		1..1	cs	Fixed Value: COMP
act		1..1	EntryReference	Base for all types and resources
entryRelationship:priorityPreference		0..1	EntryRelationship	The following entryRelationship represents the priority that the patient or a provider puts on the goal.
@typeCode		1..1	cs	Fixed Value: REFR
observation		1..1	PriorityPreference	Base for all types and resources
entryRelationship:goal		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Goal Observations where the target is a component of the source (Goal Observation HAS COMPONENT Goal Observation). The component goal (target) is a Milestone.
@typeCode		1..1	cs	Fixed Value: COMP
observation		1..1	GoalObservation	Base for all types and resources
entryRelationship:progressTowardGoal		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
observation		1..1	ProgressTowardGoalObservation	act
reference		0..*	Reference	Where it is necessary to reference an external clinical document such a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
@typeCode		1..1	cs	Fixed Value: REFR
externalDocument		1..1	ExternalDocumentReference	Base for all types and resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.statusCode.code	required	ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 from https://vsac.nlm.nih.gov
Observation.value:coded	example

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation	SHOULD contain author : author.exists()
should-effectiveTime	warning	Observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:goal-obs		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.121
@extension		1..1	st	Required Pattern: 2022-06-01
@classCode		1..1	cs	Binding: CDAActClassObservation (required) Fixed Value: OBS
@moodCode		1..1	cs	Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: GOL
id		1..*	II
code		1..1	CD	When the Goal is Social Determinant of Health Goal, the observation/code SHOULD contain exactly one [1..1] code, which SHOULD contain exactly one [1..1] @code="8689-2 "History of Social function Binding: ObservationType (example)
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	Binding: ActStatus (required)
effectiveTime		0..1	IVL_TS	effectiveTime/low represents when to start working on the goal. effectiveTime/high or effectiveTime/value represents when the goal should be met (i.e. a due date)
Slices for value		0..1		Slice: Unordered, Open by type:$this
value			ANY
value			BL
value			ED
value			ST
value			CD
value			CV
value			CE
value			CO
value			SC
value			II
value			TEL
value			AD
value			EN
value			INT
value			REAL
value			PQ
value			MO
value			TS
value			IVL_PQ
value			IVL_TS
value			PIVL_TS
value			EIVL_TS
value			SXPR_TS
value			RTO_PQ_PQ
value:coded		0..1	CD	Binding: (unbound) (example): See additional binding Additional Bindings Purpose Documentation Social Determinants of Health Goals Preferred Binding Social Determinant of Health Goals
author		0..*	AuthorParticipation	If the author is the recordTarget (patient), this is a patient goal. If the author is a provider, this is a provider goal. If both patient and provider are authors, this is a negotiated goal. If no author is present, it is assumed the document or section author(s) is the author of this goal.
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, value:typeCode
entryRelationship:refersTo		0..*	EntryRelationship	The following entryRelationship represents the relationship between a Goal Observation and another entry (usually a Health Concern Act) (Goal Observation REFERS TO Health Concern Act) already described in the CDA document instance. Rather than clone the whole entry, an Entry Reference may be used in this entryRelationship to reference this entry.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:componentEntry		0..*	EntryRelationship	The following entryRelationship represents a planned component of the goal such as Planned Encounter (V2), Planned Procedure (V2), Planned Medication Activity (V2), Planned Supply (V2), Planned Act (V2) or Planned Immunization Activity. Because these entries are already described in the Interventions Section of the CDA document instance, rather than repeating the full content of the entries, the Entry Reference template may be used to reference the entries.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:priorityPreference		0..1	EntryRelationship	The following entryRelationship represents the priority that the patient or a provider puts on the goal.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
observation	C	1..1	PriorityPreference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
entryRelationship:goal		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Goal Observations where the target is a component of the source (Goal Observation HAS COMPONENT Goal Observation). The component goal (target) is a Milestone.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
observation	C	1..1	GoalObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
entryRelationship:progressTowardGoal		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
observation	C	1..1	ProgressTowardGoalObservation	act should-text-ref-value: SHOULD contain text/reference/@value
reference		0..*	Reference	Where it is necessary to reference an external clinical document such a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
@typeCode		1..1	cs	Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR
externalDocument	C	1..1	ExternalDocumentReference	Base for all types and resources should-setId: SHOULD contain setId should-versionNumber: SHOULD contain versionNumber
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: GOL http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	example	ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.statusCode.code	required	ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 from https://vsac.nlm.nih.gov
Observation.value:coded	example
Observation.entryRelationship:refersTo.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:componentEntry.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:priorityPreference.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:goal.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:progressTowardGoal.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.reference.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain author : author.exists()
should-author	warning	Observation.entryRelationship:priorityPreference.observation	SHOULD contain author : author.exists()
should-effectiveTime	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-effectiveTime	warning	Observation.entryRelationship:priorityPreference.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-setId	warning	Observation.reference.externalDocument	SHOULD contain setId : setId.exists()
should-text-ref-value	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Observation.entryRelationship:refersTo.act, Observation.entryRelationship:componentEntry.act, Observation.entryRelationship:priorityPreference.observation, Observation.entryRelationship:progressTowardGoal.observation	SHOULD contain text/reference/@value : text.reference.value.exists()
should-versionNumber	warning	Observation.reference.externalDocument	SHOULD contain versionNumber : versionNumber.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:goal-obs		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.121
@extension		1..1	st	Required Pattern: 2022-06-01
@classCode		1..1	cs	Binding: CDAActClassObservation (required) Fixed Value: OBS
@moodCode		1..1	cs	Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: GOL
@negationInd		0..1	bl
id		1..*	II
code		1..1	CD	When the Goal is Social Determinant of Health Goal, the observation/code SHOULD contain exactly one [1..1] code, which SHOULD contain exactly one [1..1] @code="8689-2 "History of Social function Binding: ObservationType (example)
derivationExpr		0..1	ST
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@compression		0..1	cs	Binding: CDACompressionAlgorithm (required)
@integrityCheck		0..1	bin
@integrityCheckAlgorithm		0..1	cs	Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language		0..1	cs
@mediaType		0..1	cs	Binding: MediaType (example)
@representation		0..1	cs	Binding: CDABinaryDataEncoding (required)
xmlText		0..1	st	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	Binding: ActStatus (required)
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime		0..1	IVL_TS	effectiveTime/low represents when to start working on the goal. effectiveTime/high or effectiveTime/value represents when the goal should be met (i.e. a due date)
priorityCode		0..1	CE	Binding: ActPriority (example)
repeatNumber		0..1	IVL_INT
languageCode		0..1	CS	Binding: AllLanguages (required)
Slices for value		0..1		Slice: Unordered, Open by type:$this
value			ANY
value			BL
value			ED
value			ST
value			CD
value			CV
value			CE
value			CO
value			SC
value			II
value			TEL
value			AD
value			EN
value			INT
value			REAL
value			PQ
value			MO
value			TS
value			IVL_PQ
value			IVL_TS
value			PIVL_TS
value			EIVL_TS
value			SXPR_TS
value			RTO_PQ_PQ
value:coded		0..1	CD	Binding: (unbound) (example): See additional binding Additional Bindings Purpose Documentation Social Determinants of Health Goals Preferred Binding Social Determinant of Health Goals
interpretationCode		0..*	CE	Binding: CDAObservationInterpretation (required)
methodCode		0..*	CE	Binding: ObservationMethod (example)
targetSiteCode		0..*	CD
subject		0..1	Subject
specimen		0..*	Specimen
performer		0..*	Performer2
author		0..*	AuthorParticipation	If the author is the recordTarget (patient), this is a patient goal. If the author is a provider, this is a provider goal. If both patient and provider are authors, this is a negotiated goal. If no author is present, it is assumed the document or section author(s) is the author of this goal.
informant		0..*	Informant
participant		0..*	Participant2
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, value:typeCode
entryRelationship:refersTo		0..*	EntryRelationship	The following entryRelationship represents the relationship between a Goal Observation and another entry (usually a Health Concern Act) (Goal Observation REFERS TO Health Concern Act) already described in the CDA document instance. Rather than clone the whole entry, an Entry Reference may be used in this entryRelationship to reference this entry.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:componentEntry		0..*	EntryRelationship	The following entryRelationship represents a planned component of the goal such as Planned Encounter (V2), Planned Procedure (V2), Planned Medication Activity (V2), Planned Supply (V2), Planned Act (V2) or Planned Immunization Activity. Because these entries are already described in the Interventions Section of the CDA document instance, rather than repeating the full content of the entries, the Entry Reference template may be used to reference the entries.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:priorityPreference		0..1	EntryRelationship	The following entryRelationship represents the priority that the patient or a provider puts on the goal.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	PriorityPreference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:goal		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Goal Observations where the target is a component of the source (Goal Observation HAS COMPONENT Goal Observation). The component goal (target) is a Milestone.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	GoalObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:progressTowardGoal		0..*	EntryRelationship	entryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	ProgressTowardGoalObservation	act should-text-ref-value: SHOULD contain text/reference/@value
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
reference		0..*	Reference	Where it is necessary to reference an external clinical document such a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR
seperatableInd		0..1	BL
externalAct		0..1	ExternalAct
externalObservation		0..1	ExternalObservation
externalProcedure		0..1	ExternalProcedure
externalDocument	C	1..1	ExternalDocumentReference	Base for all types and resources should-setId: SHOULD contain setId should-versionNumber: SHOULD contain versionNumber
precondition		0..*	Precondition
sdtcPrecondition2		0..*	Precondition2	XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
referenceRange		0..*	InfrastructureRoot
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: CDAActRelationshipType (required) Fixed Value: REFV
observationRange		1..1	ObservationRange
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.templateId:goal-obs.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: GOL http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	example	ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType
Observation.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Observation.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Observation.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Observation.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.statusCode.code	required	ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 from https://vsac.nlm.nih.gov
Observation.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Observation.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Observation.value:coded	example
Observation.interpretationCode	required	CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
Observation.methodCode	example	ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod
Observation.entryRelationship:refersTo.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:refersTo.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:refersTo.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:componentEntry.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:componentEntry.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:componentEntry.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:priorityPreference.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:priorityPreference.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:priorityPreference.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:goal.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:goal.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:goal.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:progressTowardGoal.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:progressTowardGoal.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:progressTowardGoal.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.reference.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.reference.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.reference.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference
Observation.referenceRange.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeCode	required	Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain author : author.exists()
should-author	warning	Observation.entryRelationship:priorityPreference.observation	SHOULD contain author : author.exists()
should-effectiveTime	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-effectiveTime	warning	Observation.entryRelationship:priorityPreference.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-setId	warning	Observation.reference.externalDocument	SHOULD contain setId : setId.exists()
should-text-ref-value	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Observation.entryRelationship:refersTo.act, Observation.entryRelationship:componentEntry.act, Observation.entryRelationship:priorityPreference.observation, Observation.entryRelationship:progressTowardGoal.observation	SHOULD contain text/reference/@value : text.reference.value.exists()
should-versionNumber	warning	Observation.reference.externalDocument	SHOULD contain versionNumber : versionNumber.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

This structure is derived from Observation

Summary

Mandatory: 7 elements(6 nested mandatory elements)
Fixed: 8 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Author Participation (http://hl7.org/cda/us/ccda/StructureDefinition/AuthorParticipation)
• Entry Reference (http://hl7.org/cda/us/ccda/StructureDefinition/EntryReference)
• Priority Preference (http://hl7.org/cda/us/ccda/StructureDefinition/PriorityPreference)
• Goal Observation (http://hl7.org/cda/us/ccda/StructureDefinition/GoalObservation)
• Progress Toward Goal Observation (http://hl7.org/cda/us/ccda/StructureDefinition/ProgressTowardGoalObservation)
• External Document Reference (http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Observation.templateId
• The element 1 is sliced based on the value of Observation.value
• The element 3 is sliced based on the values of Observation.entryRelationship

Differential View

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:goal-obs		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.121
@extension		1..1	st	Required Pattern: 2022-06-01
@classCode		1..1	cs	Fixed Value: OBS
@moodCode		1..1	cs	Fixed Value: GOL
id		1..*	II
code		1..1	CD	When the Goal is Social Determinant of Health Goal, the observation/code SHOULD contain exactly one [1..1] code, which SHOULD contain exactly one [1..1] @code="8689-2 "History of Social function
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS
@nullFlavor		0..0
@code		1..1	cs	Binding: ActStatus (required)
effectiveTime		0..1	IVL_TS	effectiveTime/low represents when to start working on the goal. effectiveTime/high or effectiveTime/value represents when the goal should be met (i.e. a due date)
Slices for value		0..1	ANY, BL, ED, ST, CD, CV, CE, CO, SC, II, TEL, AD, EN, INT, REAL, PQ, MO, TS, IVL_PQ, IVL_TS, PIVL_TS, EIVL_TS, SXPR_TS, RTO_PQ_PQ	Slice: Unordered, Open by type:$this
value:coded		0..1	CD	Binding: (unbound) (example): See additional binding Additional Bindings Purpose Documentation Social Determinants of Health Goals Preferred Binding Social Determinant of Health Goals
author		0..*	AuthorParticipation	If the author is the recordTarget (patient), this is a patient goal. If the author is a provider, this is a provider goal. If both patient and provider are authors, this is a negotiated goal. If no author is present, it is assumed the document or section author(s) is the author of this goal.
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, value:typeCode
entryRelationship:refersTo		0..*	EntryRelationship	The following entryRelationship represents the relationship between a Goal Observation and another entry (usually a Health Concern Act) (Goal Observation REFERS TO Health Concern Act) already described in the CDA document instance. Rather than clone the whole entry, an Entry Reference may be used in this entryRelationship to reference this entry.
@typeCode		1..1	cs	Fixed Value: REFR
act		1..1	EntryReference	Base for all types and resources
entryRelationship:componentEntry		0..*	EntryRelationship	The following entryRelationship represents a planned component of the goal such as Planned Encounter (V2), Planned Procedure (V2), Planned Medication Activity (V2), Planned Supply (V2), Planned Act (V2) or Planned Immunization Activity. Because these entries are already described in the Interventions Section of the CDA document instance, rather than repeating the full content of the entries, the Entry Reference template may be used to reference the entries.
@typeCode		1..1	cs	Fixed Value: COMP
act		1..1	EntryReference	Base for all types and resources
entryRelationship:priorityPreference		0..1	EntryRelationship	The following entryRelationship represents the priority that the patient or a provider puts on the goal.
@typeCode		1..1	cs	Fixed Value: REFR
observation		1..1	PriorityPreference	Base for all types and resources
entryRelationship:goal		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Goal Observations where the target is a component of the source (Goal Observation HAS COMPONENT Goal Observation). The component goal (target) is a Milestone.
@typeCode		1..1	cs	Fixed Value: COMP
observation		1..1	GoalObservation	Base for all types and resources
entryRelationship:progressTowardGoal		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Fixed Value: REFR
observation		1..1	ProgressTowardGoalObservation	act
reference		0..*	Reference	Where it is necessary to reference an external clinical document such a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
@typeCode		1..1	cs	Fixed Value: REFR
externalDocument		1..1	ExternalDocumentReference	Base for all types and resources
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.statusCode.code	required	ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 from https://vsac.nlm.nih.gov
Observation.value:coded	example

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation	SHOULD contain author : author.exists()
should-effectiveTime	warning	Observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-text-ref-value	warning	Observation	SHOULD contain text/reference/@value : text.reference.value.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:goal-obs		1..1	II
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.121
@extension		1..1	st	Required Pattern: 2022-06-01
@classCode		1..1	cs	Binding: CDAActClassObservation (required) Fixed Value: OBS
@moodCode		1..1	cs	Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: GOL
id		1..*	II
code		1..1	CD	When the Goal is Social Determinant of Health Goal, the observation/code SHOULD contain exactly one [1..1] code, which SHOULD contain exactly one [1..1] @code="8689-2 "History of Social function Binding: ObservationType (example)
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	Binding: ActStatus (required)
effectiveTime		0..1	IVL_TS	effectiveTime/low represents when to start working on the goal. effectiveTime/high or effectiveTime/value represents when the goal should be met (i.e. a due date)
Slices for value		0..1		Slice: Unordered, Open by type:$this
value			ANY
value			BL
value			ED
value			ST
value			CD
value			CV
value			CE
value			CO
value			SC
value			II
value			TEL
value			AD
value			EN
value			INT
value			REAL
value			PQ
value			MO
value			TS
value			IVL_PQ
value			IVL_TS
value			PIVL_TS
value			EIVL_TS
value			SXPR_TS
value			RTO_PQ_PQ
value:coded		0..1	CD	Binding: (unbound) (example): See additional binding Additional Bindings Purpose Documentation Social Determinants of Health Goals Preferred Binding Social Determinant of Health Goals
author		0..*	AuthorParticipation	If the author is the recordTarget (patient), this is a patient goal. If the author is a provider, this is a provider goal. If both patient and provider are authors, this is a negotiated goal. If no author is present, it is assumed the document or section author(s) is the author of this goal.
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, value:typeCode
entryRelationship:refersTo		0..*	EntryRelationship	The following entryRelationship represents the relationship between a Goal Observation and another entry (usually a Health Concern Act) (Goal Observation REFERS TO Health Concern Act) already described in the CDA document instance. Rather than clone the whole entry, an Entry Reference may be used in this entryRelationship to reference this entry.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:componentEntry		0..*	EntryRelationship	The following entryRelationship represents a planned component of the goal such as Planned Encounter (V2), Planned Procedure (V2), Planned Medication Activity (V2), Planned Supply (V2), Planned Act (V2) or Planned Immunization Activity. Because these entries are already described in the Interventions Section of the CDA document instance, rather than repeating the full content of the entries, the Entry Reference template may be used to reference the entries.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
entryRelationship:priorityPreference		0..1	EntryRelationship	The following entryRelationship represents the priority that the patient or a provider puts on the goal.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
observation	C	1..1	PriorityPreference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
entryRelationship:goal		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Goal Observations where the target is a component of the source (Goal Observation HAS COMPONENT Goal Observation). The component goal (target) is a Milestone.
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
observation	C	1..1	GoalObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
entryRelationship:progressTowardGoal		0..*	EntryRelationship	entryRelationship
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
observation	C	1..1	ProgressTowardGoalObservation	act should-text-ref-value: SHOULD contain text/reference/@value
reference		0..*	Reference	Where it is necessary to reference an external clinical document such a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
@typeCode		1..1	cs	Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR
externalDocument	C	1..1	ExternalDocumentReference	Base for all types and resources should-setId: SHOULD contain setId should-versionNumber: SHOULD contain versionNumber
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: GOL http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	example	ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.statusCode.code	required	ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 from https://vsac.nlm.nih.gov
Observation.value:coded	example
Observation.entryRelationship:refersTo.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:componentEntry.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:priorityPreference.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:goal.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:progressTowardGoal.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.reference.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain author : author.exists()
should-author	warning	Observation.entryRelationship:priorityPreference.observation	SHOULD contain author : author.exists()
should-effectiveTime	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-effectiveTime	warning	Observation.entryRelationship:priorityPreference.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-setId	warning	Observation.reference.externalDocument	SHOULD contain setId : setId.exists()
should-text-ref-value	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Observation.entryRelationship:refersTo.act, Observation.entryRelationship:componentEntry.act, Observation.entryRelationship:priorityPreference.observation, Observation.entryRelationship:progressTowardGoal.observation	SHOULD contain text/reference/@value : text.reference.value.exists()
should-versionNumber	warning	Observation.reference.externalDocument	SHOULD contain versionNumber : versionNumber.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	1..1	Observation	XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, derivationExpr, text, statusCode, effectiveTime, priorityCode, repeatNumber, languageCode, value, interpretationCode, methodCode, targetSiteCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, referenceRange, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
Slices for templateId		1..*	II	Slice: Unordered, Open by value:root, value:extension
templateId:goal-obs		1..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Required Pattern: 2.16.840.1.113883.10.20.22.4.121
@extension		1..1	st	Required Pattern: 2022-06-01
@classCode		1..1	cs	Binding: CDAActClassObservation (required) Fixed Value: OBS
@moodCode		1..1	cs	Binding: XActMoodDocumentObservation (2.0.0) (required) Fixed Value: GOL
@negationInd		0..1	bl
id		1..*	II
code		1..1	CD	When the Goal is Social Determinant of Health Goal, the observation/code SHOULD contain exactly one [1..1] code, which SHOULD contain exactly one [1..1] @code="8689-2 "History of Social function Binding: ObservationType (example)
derivationExpr		0..1	ST
text		0..1	ED	SHOULD reference the portion of section narrative text corresponding to this entry
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@compression		0..1	cs	Binding: CDACompressionAlgorithm (required)
@integrityCheck		0..1	bin
@integrityCheckAlgorithm		0..1	cs	Binding: IntegrityCheckAlgorithm (2.0.0) (required)
@language		0..1	cs
@mediaType		0..1	cs	Binding: MediaType (example)
@representation		0..1	cs	Binding: CDABinaryDataEncoding (required)
xmlText		0..1	st	Allows for mixed text content. If @representation='B64', this SHALL be a base64binary string.
reference	C	0..1	TEL	value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative
thumbnail		0..1	ED
statusCode		1..1	CS	Binding: ActStatus (required)
@code		1..1	cs	Binding: ActStatus (required)
@sdtcValueSet		0..1	oid	XML Namespace: urn:hl7-org:sdtc XML: valueSet (urn:hl7-org:sdtc)
@sdtcValueSetVersion		0..1	st	XML Namespace: urn:hl7-org:sdtc XML: valueSetVersion (urn:hl7-org:sdtc)
effectiveTime		0..1	IVL_TS	effectiveTime/low represents when to start working on the goal. effectiveTime/high or effectiveTime/value represents when the goal should be met (i.e. a due date)
priorityCode		0..1	CE	Binding: ActPriority (example)
repeatNumber		0..1	IVL_INT
languageCode		0..1	CS	Binding: AllLanguages (required)
Slices for value		0..1		Slice: Unordered, Open by type:$this
value			ANY
value			BL
value			ED
value			ST
value			CD
value			CV
value			CE
value			CO
value			SC
value			II
value			TEL
value			AD
value			EN
value			INT
value			REAL
value			PQ
value			MO
value			TS
value			IVL_PQ
value			IVL_TS
value			PIVL_TS
value			EIVL_TS
value			SXPR_TS
value			RTO_PQ_PQ
value:coded		0..1	CD	Binding: (unbound) (example): See additional binding Additional Bindings Purpose Documentation Social Determinants of Health Goals Preferred Binding Social Determinant of Health Goals
interpretationCode		0..*	CE	Binding: CDAObservationInterpretation (required)
methodCode		0..*	CE	Binding: ObservationMethod (example)
targetSiteCode		0..*	CD
subject		0..1	Subject
specimen		0..*	Specimen
performer		0..*	Performer2
author		0..*	AuthorParticipation	If the author is the recordTarget (patient), this is a patient goal. If the author is a provider, this is a provider goal. If both patient and provider are authors, this is a negotiated goal. If no author is present, it is assumed the document or section author(s) is the author of this goal.
informant		0..*	Informant
participant		0..*	Participant2
Slices for entryRelationship		0..*	EntryRelationship	Slice: Unordered, Open by profile:act, profile:observation, value:typeCode
entryRelationship:refersTo		0..*	EntryRelationship	The following entryRelationship represents the relationship between a Goal Observation and another entry (usually a Health Concern Act) (Goal Observation REFERS TO Health Concern Act) already described in the CDA document instance. Rather than clone the whole entry, an Entry Reference may be used in this entryRelationship to reference this entry.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:componentEntry		0..*	EntryRelationship	The following entryRelationship represents a planned component of the goal such as Planned Encounter (V2), Planned Procedure (V2), Planned Medication Activity (V2), Planned Supply (V2), Planned Act (V2) or Planned Immunization Activity. Because these entries are already described in the Interventions Section of the CDA document instance, rather than repeating the full content of the entries, the Entry Reference template may be used to reference the entries.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act	C	1..1	EntryReference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value
encounter		0..1	Encounter
observation		0..1	Observation
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:priorityPreference		0..1	EntryRelationship	The following entryRelationship represents the priority that the patient or a provider puts on the goal.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	PriorityPreference	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:goal		0..*	EntryRelationship	The following entryRelationship represents the relationship between two Goal Observations where the target is a component of the source (Goal Observation HAS COMPONENT Goal Observation). The component goal (target) is a Milestone.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	GoalObservation	Base for all types and resources should-text-ref-value: SHOULD contain text/reference/@value should-effectiveTime: SHOULD contain effectiveTime should-author: SHOULD contain author
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
entryRelationship:progressTowardGoal		0..*	EntryRelationship	entryRelationship
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: REFR
@inversionInd		0..1	bl
@contextConductionInd		0..1	bl
@negationInd		0..1	bl
sequenceNumber		0..1	INT
seperatableInd		0..1	BL
act		0..1	Act
encounter		0..1	Encounter
observation	C	1..1	ProgressTowardGoalObservation	act should-text-ref-value: SHOULD contain text/reference/@value
observationMedia		0..1	ObservationMedia
organizer		0..1	Organizer
procedure		0..1	Procedure
regionOfInterest		0..1	RegionOfInterest
substanceAdministration		0..1	SubstanceAdministration
supply		0..1	Supply
reference		0..*	Reference	Where it is necessary to reference an external clinical document such a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		1..1	cs	Binding: x_ActRelationshipExternalReference (required) Fixed Value: REFR
seperatableInd		0..1	BL
externalAct		0..1	ExternalAct
externalObservation		0..1	ExternalObservation
externalProcedure		0..1	ExternalProcedure
externalDocument	C	1..1	ExternalDocumentReference	Base for all types and resources should-setId: SHOULD contain setId should-versionNumber: SHOULD contain versionNumber
precondition		0..*	Precondition
sdtcPrecondition2		0..*	Precondition2	XML Namespace: urn:hl7-org:sdtc XML: precondition2 (urn:hl7-org:sdtc)
referenceRange		0..*	InfrastructureRoot
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
realmCode		0..*	CS
typeId		0..1	II
@nullFlavor		0..1	cs	Binding: CDANullFlavor (required)
@assigningAuthorityName		0..1	st
@displayable		0..1	bl
@root		1..1	oid, uuid, ruid	Fixed Value: 2.16.840.1.113883.1.3
@extension		1..1	st
templateId		0..*	II
@typeCode		0..1	cs	Binding: CDAActRelationshipType (required) Fixed Value: REFV
observationRange		1..1	ObservationRange
sdtcInFulfillmentOf1		0..*	InFulfillmentOf1	XML Namespace: urn:hl7-org:sdtc XML: inFulfillmentOf1 (urn:hl7-org:sdtc)
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.templateId:goal-obs.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.classCode	required	Fixed Value: OBS http://hl7.org/cda/stds/core/ValueSet/CDAActClassObservation
Observation.moodCode	required	Fixed Value: GOL http://terminology.hl7.org/ValueSet/v3-xActMoodDocumentObservation|2.0.0
Observation.code	example	ObservationType http://terminology.hl7.org/ValueSet/v3-ObservationType
Observation.text.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.text.compression	required	CDACompressionAlgorithm http://hl7.org/cda/stds/core/ValueSet/CDACompressionAlgorithm
Observation.text.integrityCheckAlgorithm	required	IntegrityCheckAlgorithm http://terminology.hl7.org/ValueSet/v3-IntegrityCheckAlgorithm|2.0.0
Observation.text.mediaType	example	MediaType http://terminology.hl7.org/ValueSet/v3-MediaType
Observation.text.representation	required	BinaryDataEncoding http://hl7.org/cda/stds/core/ValueSet/BinaryDataEncoding
Observation.statusCode	required	ActStatus http://terminology.hl7.org/ValueSet/v3-ActStatus
Observation.statusCode.code	required	ActStatus http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933 from https://vsac.nlm.nih.gov
Observation.priorityCode	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Observation.languageCode	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages from the FHIR Standard
Observation.value:coded	example
Observation.interpretationCode	required	CDAObservationInterpretation http://hl7.org/cda/stds/core/ValueSet/CDAObservationInterpretation
Observation.methodCode	example	ObservationMethod http://terminology.hl7.org/ValueSet/v3-ObservationMethod
Observation.entryRelationship:refersTo.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:refersTo.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:refersTo.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:componentEntry.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:componentEntry.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:componentEntry.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:priorityPreference.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:priorityPreference.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:priorityPreference.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:goal.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:goal.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:goal.typeCode	required	Fixed Value: COMP http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.entryRelationship:progressTowardGoal.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:progressTowardGoal.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.entryRelationship:progressTowardGoal.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipEntryRelationship
Observation.reference.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.reference.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.reference.typeCode	required	Fixed Value: REFR http://terminology.hl7.org/ValueSet/v3-xActRelationshipExternalReference
Observation.referenceRange.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeId.nullFlavor	required	CDANullFlavor http://hl7.org/cda/stds/core/ValueSet/CDANullFlavor
Observation.referenceRange.typeCode	required	Fixed Value: REFV http://hl7.org/cda/stds/core/ValueSet/CDAActRelationshipType

Constraints

Id	Grade	Path(s)	Details	Requirements
should-author	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain author : author.exists()
should-author	warning	Observation.entryRelationship:priorityPreference.observation	SHOULD contain author : author.exists()
should-effectiveTime	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-effectiveTime	warning	Observation.entryRelationship:priorityPreference.observation	SHOULD contain effectiveTime : effectiveTime.exists()
should-setId	warning	Observation.reference.externalDocument	SHOULD contain setId : setId.exists()
should-text-ref-value	warning	Observation, Observation.entryRelationship:goal.observation	SHOULD contain text/reference/@value : text.reference.value.exists()
should-text-ref-value	warning	Observation.entryRelationship:refersTo.act, Observation.entryRelationship:componentEntry.act, Observation.entryRelationship:priorityPreference.observation, Observation.entryRelationship:progressTowardGoal.observation	SHOULD contain text/reference/@value : text.reference.value.exists()
should-versionNumber	warning	Observation.reference.externalDocument	SHOULD contain versionNumber : versionNumber.exists()
value-starts-octothorpe	error	Observation.text.reference	If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#')

This structure is derived from Observation

Summary

Mandatory: 7 elements(6 nested mandatory elements)
Fixed: 8 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Author Participation (http://hl7.org/cda/us/ccda/StructureDefinition/AuthorParticipation)
• Entry Reference (http://hl7.org/cda/us/ccda/StructureDefinition/EntryReference)
• Priority Preference (http://hl7.org/cda/us/ccda/StructureDefinition/PriorityPreference)
• Goal Observation (http://hl7.org/cda/us/ccda/StructureDefinition/GoalObservation)
• Progress Toward Goal Observation (http://hl7.org/cda/us/ccda/StructureDefinition/ProgressTowardGoalObservation)
• External Document Reference (http://hl7.org/cda/us/ccda/StructureDefinition/ExternalDocumentReference)

Slices

This structure defines the following Slices:

• The element 2 is sliced based on the values of Observation.templateId
• The element 1 is sliced based on the value of Observation.value
• The element 3 is sliced based on the values of Observation.entryRelationship