HL7 FHIR® US Core Implementation Guide CI Build

US Core, published by HL7 International - US Realm Steering Committee. This is not an authorized publication; it is the continuous build for version 3.1.1). This version is based on the current content of https://github.com/HL7/US-Core-R4/ and changes regularly. See the Directory of published versions

StructureDefinition-us-core-goal

This profile sets minimum expectations for the Goal resource to record, search, and fetch Goal information associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile.

Example Usage Scenarios:

The following are example usage scenarios for the US Core-Goal profile:

Mandatory and Must Support Data Elements

The following data-elements are mandatory (i.e data MUST be present) or must be supported if the data is present in the sending system (Must Support definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Goal must have:

  1. a status
  2. text description of the goal
  3. a patient

Each Goal must support:

  1. target date(s):

Profile specific implementation guidance:

  • none

Examples

Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal

Published on Tue Jul 21 00:00:00 UTC 2020 as active by the HL7 US Realm Steering Committee.

This profile builds on Goal


Goal

Summary of the Mandatory Requirements

  1. A code in Goal.lifecycleStatus with a required binding to GoalLifecycleStatus
  2. A CodeableConcept in Goal.description with an example binding to SNOMED CT Clinical Findings
  3. A Patient Reference in Goal.subject

Summary of the Must Support Requirements

  1. One or more Targets in Goal.target with the following constraints: Goal.target.measure is required if Goal.target.detail is populated
    • which should have a date value in Goal.target.dueDate

Summary of Constraints

  1. Goal.target.measure is required if Goal.target.detail is populated
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*GoalDescribes the intended objective(s) for a patient, group or organization
... lifecycleStatus S1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... description S1..1CodeableConceptCode or text describing goal
... subject S1..1Reference(US Core Patient Profile)Who this goal is intended for
... target S0..*BackboneElementTarget outcome for the goal
.... dueDate S0..1dateReach goal on or before

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal I0..*GoalDescribes the intended objective(s) for a patient, group or organization
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier I0..*IdentifierExternal Ids for this goal
... lifecycleStatus ?!SΣI1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus ΣI0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred)
... category ΣI0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example)
... priority ΣI0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred)
... description SΣI1..1CodeableConceptCode or text describing goal
Binding: SNOMEDCTClinicalFindings (example)
... subject SΣI1..1Reference(US Core Patient Profile)Who this goal is intended for
... start[x] ΣI0..1When goal pursuit begins
Binding: GoalStartEvent (example)
.... startDatedate
.... startCodeableConceptCodeableConcept
... target SI0..*BackboneElementTarget outcome for the goal
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure ΣI0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example)
.... detail[x] ΣI0..1The target value to be achieved
Binding: (unbound) (example)
..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] ΣI0..1(Slice Definition)Reach goal on or before
Slice: Unordered, Closed by type:$this
..... due[x]:dueDate SΣI0..1dateReach goal on or before
... statusDate ΣI0..1dateWhen goal status took effect
... statusReason I0..1stringReason for current status
... expressedBy ΣI0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)Who's responsible for creating Goal?
... addresses I0..*Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)Issues addressed by this goal
... note I0..*AnnotationComments about the goal
... outcomeCode I0..*CodeableConceptWhat result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (example)
... outcomeReference I0..*Reference(Observation)Observation that resulted from goal

doco Documentation for this format

Goal

Summary of the Mandatory Requirements

  1. A code in Goal.lifecycleStatus with a required binding to GoalLifecycleStatus
  2. A CodeableConcept in Goal.description with an example binding to SNOMED CT Clinical Findings
  3. A Patient Reference in Goal.subject

Summary of the Must Support Requirements

  1. One or more Targets in Goal.target with the following constraints: Goal.target.measure is required if Goal.target.detail is populated
    • which should have a date value in Goal.target.dueDate

Summary of Constraints

  1. Goal.target.measure is required if Goal.target.detail is populated

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal 0..*GoalDescribes the intended objective(s) for a patient, group or organization
... lifecycleStatus S1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... description S1..1CodeableConceptCode or text describing goal
... subject S1..1Reference(US Core Patient Profile)Who this goal is intended for
... target S0..*BackboneElementTarget outcome for the goal
.... dueDate S0..1dateReach goal on or before

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Goal I0..*GoalDescribes the intended objective(s) for a patient, group or organization
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier I0..*IdentifierExternal Ids for this goal
... lifecycleStatus ?!SΣI1..1codeproposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus ΣI0..1CodeableConceptin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred)
... category ΣI0..*CodeableConceptE.g. Treatment, dietary, behavioral, etc.
Binding: GoalCategory (example)
... priority ΣI0..1CodeableConcepthigh-priority | medium-priority | low-priority
Binding: GoalPriority (preferred)
... description SΣI1..1CodeableConceptCode or text describing goal
Binding: SNOMEDCTClinicalFindings (example)
... subject SΣI1..1Reference(US Core Patient Profile)Who this goal is intended for
... start[x] ΣI0..1When goal pursuit begins
Binding: GoalStartEvent (example)
.... startDatedate
.... startCodeableConceptCodeableConcept
... target SI0..*BackboneElementTarget outcome for the goal
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... measure ΣI0..1CodeableConceptThe parameter whose value is being tracked
Binding: LOINCCodes (example)
.... detail[x] ΣI0..1The target value to be achieved
Binding: (unbound) (example)
..... detailQuantityQuantity
..... detailRangeRange
..... detailCodeableConceptCodeableConcept
..... detailStringstring
..... detailBooleanboolean
..... detailIntegerinteger
..... detailRatioRatio
.... due[x] ΣI0..1(Slice Definition)Reach goal on or before
Slice: Unordered, Closed by type:$this
..... due[x]:dueDate SΣI0..1dateReach goal on or before
... statusDate ΣI0..1dateWhen goal status took effect
... statusReason I0..1stringReason for current status
... expressedBy ΣI0..1Reference(Patient | Practitioner | PractitionerRole | RelatedPerson)Who's responsible for creating Goal?
... addresses I0..*Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment)Issues addressed by this goal
... note I0..*AnnotationComments about the goal
... outcomeCode I0..*CodeableConceptWhat result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (example)
... outcomeReference I0..*Reference(Observation)Observation that resulted from goal

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron


Quick Start

Below is an overview of the required set of Server RESTful FHIR interactions - for example, search and read operations - for this profile. See the Conformance requirements for a complete list of supported RESTful interactions for this IG.

  • The syntax used to describe the interactions is described here.
  • See the General Guidance section for additional rules and expectations when a server requires status parameters.
  • See the General Guidance section for additional guidance on searching for multiple patients.

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported.:

  1. SHALL support searching for all goals for a patient using the patient search parameter:

    GET [base]/Goal?patient=[reference]

    Example:

    1. GET [base]/Goal?patient=1137192

    Implementation Notes: Fetches a bundle of all Goal resources for the specified patient (how to search by reference)

Optional Search Parameters:

The following search parameter combinations SHOULD be supported.:

  1. SHOULD support searching using the combination of the patient and lifecycle-status search parameters:

    GET [base]/Goal?patient=[reference]&lifecycle-status={system|}[code]

    Example:

    1. GET [base]/Goal?patient=1137192&lifecycle-status=active

    Implementation Notes: Fetches a bundle of all Goal resources for the specified patient and lifecycle-status (how to search by reference and how to search by token)

  2. SHOULD support searching using the combination of the patient and target-date search parameters:

    • including support for these target-date comparators: gt,lt,ge,le
    • including optional support for composite AND search on target-date (e.g.target-date=[date]&target-date=[date]]&...)

    GET [base]/Goal?patient=[reference]&target-date={gt|lt|ge|le}[date]{&target-date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]/Goal?patient=1137192&target-date=ge2015-01-14&target-date=le2019-01-14

    Implementation Notes: Fetches a bundle of all Goal resources for the specified patient and target-date (how to search by reference and how to search by date)