Advance Care Planning (PZP)
1.0.0-rc1 - trial-use

Advance Care Planning (PZP), published by IKNL. This guide is not an authorized publication; it is the continuous build for version 1.0.0-rc1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IKNL/PZP-FHIR-R4/ and changes regularly. See the Directory of published versions

## Resource Profile: Medical Policy Goal

Official URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Medical-Policy-Goal | Version: 1.0.0-rc1
Draft as of 2025-10-31 | Computable Name: ACPMedicalPolicyGoal
Copyright/Legal: Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.

The primary, agreed-upon goal of a patient's medical treatment policy. Based on Goal resource.

Usages:

- Examples for this Profile: Goal/F1-ACP-Medical-Policy-Goal and Goal/P2-ACP-Medical-Policy-Goal

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal |  | 0..* | Goal(4.0.1) | Describes the intended objective(s) for a patient, group or organization
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference"
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
lifecycleStatus | ?!Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required): Codes that reflect the current state of a goal and whether the goal is still being targeted.
description | O Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: MedicalPolicyGoalVS (1.0.0-rc1) (required)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
subject | O Σ | 1..1 | Reference(Patient(1.0.0-rc1)) | Who this goal is intended for
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for start[x] | Σ | 0..1 |  | When goal pursuit begins Slice: Unordered, Open by type:$this Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate |  |  | date |
startCodeableConcept |  |  | CodeableConcept |
start[x]:startDate | O Σ | 0..1 | date | When goal pursuit begins
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Goal.lifecycleStatus | Base | required | GoalLifecycleStatus | 📍4.0.1 | FHIR Std.
Goal.description | Base | required | Most Important Agreed-upon Goal of Medical Policy | 📍1.0.0-rc1 | This IG
Goal.start[x] | Base | example | Goal start event | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Goal | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Goal | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Goal | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | Goal.implicitRules, Goal.extension, Goal.extension:encounter, Goal.extension:encounter.value[x], Goal.modifierExtension, Goal.lifecycleStatus, Goal.description, Goal.subject, Goal.start[x], Goal.start[x]:startDate | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Goal.extension, Goal.extension:encounter, Goal.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from Goal

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal |  | 0..* | Goal(4.0.1) | Describes the intended objective(s) for a patient, group or organization
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
description | O | 1..1 | CodeableConcept | Code or text describing goal Binding: MedicalPolicyGoalVS (1.0.0-rc1) (required)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
subject | O | 1..1 | Reference(Patient(1.0.0-rc1)) | Who this goal is intended for
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for start[x] |  | 0..1 | date, CodeableConcept | When goal pursuit begins Slice: Unordered, Open by type:$this
start[x]:startDate | O | 0..1 | date | When goal pursuit begins
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
note |  |  |  |
text | O | 1..1 | markdown | The annotation - text content (as markdown)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Goal.description | Base | required | Most Important Agreed-upon Goal of Medical Policy | 📍1.0.0-rc1 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal |  | 0..* | Goal(4.0.1) | Describes the intended objective(s) for a patient, group or organization
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference"
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
identifier |  | 0..* | Identifier | External Ids for this goal
lifecycleStatus | ?!Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required): Codes that reflect the current state of a goal and whether the goal is still being targeted.
achievementStatus | Σ | 0..1 | CodeableConcept | in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.
category | Σ | 0..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Binding: GoalCategory (example): Codes for grouping and sorting goals.
priority | Σ | 0..1 | CodeableConcept | high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal.
description | O Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: MedicalPolicyGoalVS (1.0.0-rc1) (required)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
subject | O Σ | 1..1 | Reference(Patient(1.0.0-rc1)) | Who this goal is intended for
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for start[x] | Σ | 0..1 |  | When goal pursuit begins Slice: Unordered, Open by type:$this Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate |  |  | date |
startCodeableConcept |  |  | CodeableConcept |
start[x]:startDate | O Σ | 0..1 | date | When goal pursuit begins
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
target | C | 0..* | BackboneElement | Target outcome for the goal Constraints: gol-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
measure | Σ C | 0..1 | CodeableConcept | The parameter whose value is being tracked Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
detail[x] | Σ C | 0..1 |  | The target value to be achieved Binding Description: (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.
detailQuantity |  |  | Quantity |
detailRange |  |  | Range |
detailCodeableConcept |  |  | CodeableConcept |
detailString |  |  | string |
detailBoolean |  |  | boolean |
detailInteger |  |  | integer |
detailRatio |  |  | Ratio |
due[x] | Σ | 0..1 |  | Reach goal on or before
dueDate |  |  | date |
dueDuration |  |  | Duration |
statusDate | Σ | 0..1 | date | When goal status took effect
statusReason |  | 0..1 | string | Reason for current status
expressedBy | Σ | 0..1 | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson) | Who's responsible for creating Goal?
addresses |  | 0..* | Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment) | Issues addressed by this goal
note |  | 0..* | Annotation | Comments about the goal
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | O Σ | 1..1 | markdown | The annotation - text content (as markdown)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
outcomeCode |  | 0..* | CodeableConcept | What result was achieved regarding the goal? Binding: SNOMEDCTClinicalFindings (example): The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months".
outcomeReference |  | 0..* | Reference(Observation) | Observation that resulted from goal
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Goal.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Goal.lifecycleStatus | Base | required | GoalLifecycleStatus | 📍4.0.1 | FHIR Std.
Goal.achievementStatus | Base | preferred | Goal achievement status | 📍4.0.1 | FHIR Std.
Goal.category | Base | example | Goal category | 📍4.0.1 | FHIR Std.
Goal.priority | Base | preferred | Goal priority | 📍4.0.1 | FHIR Std.
Goal.description | Base | required | Most Important Agreed-upon Goal of Medical Policy | 📍1.0.0-rc1 | This IG
Goal.start[x] | Base | example | Goal start event | 📍4.0.1 | FHIR Std.
Goal.target.measure | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Goal.target.detail[x] | Base | example |  | Not State | Unknown
Goal.outcomeCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Goal | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Goal | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Goal | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | Goal.meta, Goal.implicitRules, Goal.language, Goal.text, Goal.extension, Goal.extension:encounter, Goal.extension:encounter.value[x], Goal.modifierExtension, Goal.identifier, Goal.lifecycleStatus, Goal.achievementStatus, Goal.category, Goal.priority, Goal.description, Goal.subject, Goal.start[x], Goal.start[x]:startDate, Goal.target, Goal.target.extension, Goal.target.modifierExtension, Goal.target.measure, Goal.target.detail[x], Goal.target.due[x], Goal.statusDate, Goal.statusReason, Goal.expressedBy, Goal.addresses, Goal.note, Goal.note.extension, Goal.note.author[x], Goal.note.time, Goal.note.text, Goal.outcomeCode, Goal.outcomeReference | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Goal.extension, Goal.extension:encounter, Goal.modifierExtension, Goal.target.extension, Goal.target.modifierExtension, Goal.note.extension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
gol-1 | error | Goal.target | Goal.target.measure is required if Goal.target.detail is populated | `(detail.exists() and measure.exists()) or detail.exists().not()`

This structure is derived from Goal

Summary

Structures

This structure refers to these other structures:

- Encounter (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Encounter|1.0.0-rc1)
- Patient (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Patient|1.0.0-rc1)

Extensions

This structure refers to these extensions:

- https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference|1.0.0-rc1

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Goal.start[x]

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal |  | 0..* | Goal(4.0.1) | Describes the intended objective(s) for a patient, group or organization
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference Constraints: ext-1
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference"
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
lifecycleStatus | ?!Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required): Codes that reflect the current state of a goal and whether the goal is still being targeted.
description | O Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: MedicalPolicyGoalVS (1.0.0-rc1) (required)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
subject | O Σ | 1..1 | Reference(Patient(1.0.0-rc1)) | Who this goal is intended for
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for start[x] | Σ | 0..1 |  | When goal pursuit begins Slice: Unordered, Open by type:$this Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate |  |  | date |
startCodeableConcept |  |  | CodeableConcept |
start[x]:startDate | O Σ | 0..1 | date | When goal pursuit begins
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Goal.lifecycleStatus | Base | required | GoalLifecycleStatus | 📍4.0.1 | FHIR Std.
Goal.description | Base | required | Most Important Agreed-upon Goal of Medical Policy | 📍1.0.0-rc1 | This IG
Goal.start[x] | Base | example | Goal start event | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Goal | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Goal | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Goal | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | Goal.implicitRules, Goal.extension, Goal.extension:encounter, Goal.extension:encounter.value[x], Goal.modifierExtension, Goal.lifecycleStatus, Goal.description, Goal.subject, Goal.start[x], Goal.start[x]:startDate | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Goal.extension, Goal.extension:encounter, Goal.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from Goal

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal |  | 0..* | Goal(4.0.1) | Describes the intended objective(s) for a patient, group or organization
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
description | O | 1..1 | CodeableConcept | Code or text describing goal Binding: MedicalPolicyGoalVS (1.0.0-rc1) (required)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
subject | O | 1..1 | Reference(Patient(1.0.0-rc1)) | Who this goal is intended for
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for start[x] |  | 0..1 | date, CodeableConcept | When goal pursuit begins Slice: Unordered, Open by type:$this
start[x]:startDate | O | 0..1 | date | When goal pursuit begins
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
note |  |  |  |
text | O | 1..1 | markdown | The annotation - text content (as markdown)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Goal.description | Base | required | Most Important Agreed-upon Goal of Medical Policy | 📍1.0.0-rc1 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Goal |  | 0..* | Goal(4.0.1) | Describes the intended objective(s) for a patient, group or organization
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:encounter |  | 0..1 | (Complex) | ext Encounter Reference URL: https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference Constraints: ext-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url Constraints: ext-1
url |  | 1..1 | uri | "https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference"
value[x] |  | 0..1 | Reference(Encounter(1.0.0-rc1)) | Encounter
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
identifier |  | 0..* | Identifier | External Ids for this goal
lifecycleStatus | ?!Σ | 1..1 | code | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected Binding: GoalLifecycleStatus (required): Codes that reflect the current state of a goal and whether the goal is still being targeted.
achievementStatus | Σ | 0..1 | CodeableConcept | in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.
category | Σ | 0..* | CodeableConcept | E.g. Treatment, dietary, behavioral, etc. Binding: GoalCategory (example): Codes for grouping and sorting goals.
priority | Σ | 0..1 | CodeableConcept | high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal.
description | O Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: MedicalPolicyGoalVS (1.0.0-rc1) (required)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
subject | O Σ | 1..1 | Reference(Patient(1.0.0-rc1)) | Who this goal is intended for
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
Slices for start[x] | Σ | 0..1 |  | When goal pursuit begins Slice: Unordered, Open by type:$this Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal.
startDate |  |  | date |
startCodeableConcept |  |  | CodeableConcept |
start[x]:startDate | O Σ | 0..1 | date | When goal pursuit begins
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
target | C | 0..* | BackboneElement | Target outcome for the goal Constraints: gol-1
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
measure | Σ C | 0..1 | CodeableConcept | The parameter whose value is being tracked Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
detail[x] | Σ C | 0..1 |  | The target value to be achieved Binding Description: (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.
detailQuantity |  |  | Quantity |
detailRange |  |  | Range |
detailCodeableConcept |  |  | CodeableConcept |
detailString |  |  | string |
detailBoolean |  |  | boolean |
detailInteger |  |  | integer |
detailRatio |  |  | Ratio |
due[x] | Σ | 0..1 |  | Reach goal on or before
dueDate |  |  | date |
dueDuration |  |  | Duration |
statusDate | Σ | 0..1 | date | When goal status took effect
statusReason |  | 0..1 | string | Reason for current status
expressedBy | Σ | 0..1 | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson) | Who's responsible for creating Goal?
addresses |  | 0..* | Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment) | Issues addressed by this goal
note |  | 0..* | Annotation | Comments about the goal
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | O Σ | 1..1 | markdown | The annotation - text content (as markdown)
Obligations | Actor
SHALL:populate-if-known | ACP Actor Provider
SHALL:no-error | ACP Actor Consulter
outcomeCode |  | 0..* | CodeableConcept | What result was achieved regarding the goal? Binding: SNOMEDCTClinicalFindings (example): The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months".
outcomeReference |  | 0..* | Reference(Observation) | Observation that resulted from goal
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Goal.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Goal.lifecycleStatus | Base | required | GoalLifecycleStatus | 📍4.0.1 | FHIR Std.
Goal.achievementStatus | Base | preferred | Goal achievement status | 📍4.0.1 | FHIR Std.
Goal.category | Base | example | Goal category | 📍4.0.1 | FHIR Std.
Goal.priority | Base | preferred | Goal priority | 📍4.0.1 | FHIR Std.
Goal.description | Base | required | Most Important Agreed-upon Goal of Medical Policy | 📍1.0.0-rc1 | This IG
Goal.start[x] | Base | example | Goal start event | 📍4.0.1 | FHIR Std.
Goal.target.measure | Base | example | LOINC Codes | 📍4.0.1 | FHIR Std.
Goal.target.detail[x] | Base | example |  | Not State | Unknown
Goal.outcomeCode | Base | example | SNOMED CT Clinical Findings | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Goal | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Goal | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | Goal | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Goal | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | Goal.meta, Goal.implicitRules, Goal.language, Goal.text, Goal.extension, Goal.extension:encounter, Goal.extension:encounter.value[x], Goal.modifierExtension, Goal.identifier, Goal.lifecycleStatus, Goal.achievementStatus, Goal.category, Goal.priority, Goal.description, Goal.subject, Goal.start[x], Goal.start[x]:startDate, Goal.target, Goal.target.extension, Goal.target.modifierExtension, Goal.target.measure, Goal.target.detail[x], Goal.target.due[x], Goal.statusDate, Goal.statusReason, Goal.expressedBy, Goal.addresses, Goal.note, Goal.note.extension, Goal.note.author[x], Goal.note.time, Goal.note.text, Goal.outcomeCode, Goal.outcomeReference | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Goal.extension, Goal.extension:encounter, Goal.modifierExtension, Goal.target.extension, Goal.target.modifierExtension, Goal.note.extension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
gol-1 | error | Goal.target | Goal.target.measure is required if Goal.target.detail is populated | `(detail.exists() and measure.exists()) or detail.exists().not()`

This structure is derived from Goal

Summary

Structures

This structure refers to these other structures:

- Encounter (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Encounter|1.0.0-rc1)
- Patient (https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ACP-Patient|1.0.0-rc1)

Extensions

This structure refers to these extensions:

- https://api.iknl.nl/docs/pzp/r4/StructureDefinition/ext-EncounterReference|1.0.0-rc1

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Goal.start[x]

Other representations of profile: CSV, Excel, Schematron