This page is part of the 臺灣核心實作指引(TW Core IG) (v0.3.1: Releases) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Active as of 2024-10-22 |
Definitions for the Goal-twcore resource profile.
Guidance on how to interpret the contents of this table can be found here
Guidance on how to interpret the contents of this table can be found here
0. Goal | |
Definition | Describes the intended objective(s) for a patient, group or organization care, for example, weight loss, restoring an activity of daily living, obtaining herd immunity via immunization, meeting a process improvement objective, etc. |
Short | Describes the intended objective(s) for a patient, group or organization |
Comments | Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline. |
Control | 0..* |
Is Modifier | false |
Summary | false |
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) |
2. Goal.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Short | A set of rules under which this content was created |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
Control | 0..1 |
Type | uri |
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
4. Goal.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
Summary | false |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
6. Goal.lifecycleStatus | |
Definition | The state of the goal throughout its lifecycle. |
Short | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected |
Comments | This element is labeled as a modifier because the lifecycleStatus contains codes that mark the resource as not currently valid. |
Control | 1..1 |
Binding | The codes SHALL be taken from GoalLifecycleStatushttp://hl7.org/fhir/ValueSet/goal-status|4.0.1 (required to http://hl7.org/fhir/ValueSet/goal-status|4.0.1 )Codes that reflect the current state of a goal and whether the goal is still being targeted. |
Type | code |
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | true |
Requirements | Allows knowing whether goal needs to be further tracked. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
8. Goal.description | |
Definition | Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding". |
Short | Code or text describing goal |
Comments | If no code is available, use CodeableConcept.text. |
Control | 1..1 |
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findings (extensible to http://hl7.org/fhir/ValueSet/clinical-findings ) |
Type | CodeableConcept |
Is Modifier | false |
Must Support | true |
Summary | true |
Requirements | Without a description of what's trying to be achieved, element has no purpose. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
10. Goal.subject | |
Definition | Identifies the patient, group or organization for whom the goal is being established. |
Short | Who this goal is intended for |
Control | 1..1 |
Type | Reference(TW Core Patient, Group, TW Core Organization, Patient, Organization) |
Is Modifier | false |
Must Support | true |
Must Support Types | Reference(TW Core Patient) |
Summary | true |
Requirements | Subject is optional to support annonymized reporting. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
12. Goal.start[x] | |
Definition | The date or event after which the goal should begin being pursued. |
Short | When goal pursuit begins |
Control | 0..1 |
Binding | For example codes, see GoalStartEventhttp://hl7.org/fhir/ValueSet/goal-start-event (example to http://hl7.org/fhir/ValueSet/goal-start-event )Codes describing events that can trigger the initiation of a goal. |
Type | Choice of: date, CodeableConcept |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Must Support Types | date |
Summary | true |
Requirements | Goals can be established prior to there being an intention to start pursuing them; e.g. Goals for post-surgical recovery established prior to surgery. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
14. Goal.target | |
Definition | Indicates what should be done by when. |
Short | Target outcome for the goal |
Comments | When multiple targets are present for a single goal instance, all targets must be met for the overall goal to be met. |
Control | 0..* This element is affected by the following invariants: gol-1 |
Type | BackboneElement |
Is Modifier | false |
Must Support | true |
Summary | false |
Requirements | Allows the progress of the goal to be monitored against an observation or due date. Target is 0..* to support Observations with multiple components, such as blood pressure goals with both a systolic and diastolic target. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) gol-1: Goal.target.measure is required if Goal.target.detail is populated ( (detail.exists() and measure.exists()) or detail.exists().not() )gol-1: Goal.target.measure is required if Goal.target.detail is populated ((detail.exists() and measure.exists()) or detail.exists().not()) |
16. Goal.target.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Short | Extensions that cannot be ignored even if unrecognized |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Alternate Names | extensions, user content, modifiers |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
18. Goal.target.due[x] | |
Definition | Indicates either the date or the duration after start by which the goal should be met. |
Short | Reach goal on or before |
Control | 0..1 |
Type | Choice of: date, Duration |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Must Support Types | date |
Summary | true |
Requirements | Identifies when the goal should be evaluated. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
20. Goal.expressedBy | |
Definition | Indicates whose goal this is - patient goal, practitioner goal, etc. |
Short | Who's responsible for creating Goal? |
Comments | This is the individual responsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.). |
Control | 0..1 |
Type | Reference(TW Core Patient, TW Core Practitioner, TW Core PractitionerRole, TW Core RelatedPerson, Patient, Practitioner, PractitionerRole, RelatedPerson) |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
22. Goal.addresses | |
Definition | The identified conditions and other health record elements that are intended to be addressed by the goal. |
Short | Issues addressed by this goal |
Control | 0..* |
Type | Reference(TW Core Condition, TW Core Observation Clinical Result, TW Core MedicationStatement, NutritionOrder, TW Core ServiceRequest, RiskAssessment, Condition, Observation, MedicationStatement, ServiceRequest) |
Is Modifier | false |
Summary | false |
Requirements | Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
24. Goal.outcomeReference | |
Definition | Details of what's changed (or not changed). |
Short | Observation that resulted from goal |
Comments | The goal outcome is independent of the outcome of the related activities. For example, if the Goal is to achieve a target body weight of 150 lb and a care plan activity is defined to diet, then the care plan’s activity outcome could be calories consumed whereas goal outcome is an observation for the actual body weight measured. |
Control | 0..* |
Type | Reference(TW Core Observation Clinical Result, Observation) |
Is Modifier | false |
Summary | false |
Requirements | Outcome tracking is a key aspect of care planning. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. Goal | |||||
Definition | Describes the intended objective(s) for a patient, group or organization care, for example, weight loss, restoring an activity of daily living, obtaining herd immunity via immunization, meeting a process improvement objective, etc. | ||||
Short | Describes the intended objective(s) for a patient, group or organization | ||||
Comments | Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline. | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty() )dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty() )dom-6: A resource should have narrative for robust management ( text.`div`.exists() ) | ||||
2. Goal.id | |||||
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
Short | Logical id of this artifact | ||||
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
Summary | true | ||||
4. Goal.meta | |||||
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | ||||
Short | Metadata about the resource | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
6. Goal.implicitRules | |||||
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
Short | A set of rules under which this content was created | ||||
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
8. Goal.language | |||||
Definition | The base language in which the resource is written. | ||||
Short | Language of the resource content | ||||
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
10. Goal.text | |||||
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||||
Short | Text summary of the resource, for human interpretation | ||||
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | ||||
Control | 0..1 | ||||
Type | Narrative | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | narrative, html, xhtml, display | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
12. Goal.contained | |||||
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||||
Short | Contained, inline Resources | ||||
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | ||||
Control | 0..* | ||||
Type | Resource | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||
14. Goal.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
16. Goal.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Summary | false | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
18. Goal.identifier | |||||
Definition | Business identifiers assigned to this goal by the performer or other systems which remain constant as the resource is updated and propagates from server to server. | ||||
Short | External Ids for this goal | ||||
Comments | This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Allows identification of the goal as it is known by various participating systems and in a way that remains consistent across servers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
20. Goal.lifecycleStatus | |||||
Definition | The state of the goal throughout its lifecycle. | ||||
Short | proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected | ||||
Comments | This element is labeled as a modifier because the lifecycleStatus contains codes that mark the resource as not currently valid. | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from GoalLifecycleStatus (required to http://hl7.org/fhir/ValueSet/goal-status|4.0.1 )Codes that reflect the current state of a goal and whether the goal is still being targeted. | ||||
Type | code | ||||
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Allows knowing whether goal needs to be further tracked. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
22. Goal.achievementStatus | |||||
Definition | Describes the progression, or lack thereof, towards the goal against the target. | ||||
Short | in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from GoalAchievementStatus (preferred to http://hl7.org/fhir/ValueSet/goal-achievement )Indicates the progression, or lack thereof, towards the goal against the target. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
24. Goal.category | |||||
Definition | Indicates a category the goal falls within. | ||||
Short | E.g. Treatment, dietary, behavioral, etc. | ||||
Control | 0..* | ||||
Binding | For example codes, see GoalCategory (example to http://hl7.org/fhir/ValueSet/goal-category )Codes for grouping and sorting goals. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows goals to be filtered and sorted. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
26. Goal.priority | |||||
Definition | Identifies the mutually agreed level of importance associated with reaching/sustaining the goal. | ||||
Short | high-priority | medium-priority | low-priority | ||||
Comments | Extensions are available to track priorities as established by each participant (i.e. Priority from the patient's perspective, different practitioners' perspectives, family member's perspectives) The ordinal extension on Coding can be used to convey a numerically comparable ranking to priority. (Keep in mind that different coding systems may use a "low value=important". | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from GoalPriority (preferred to http://hl7.org/fhir/ValueSet/goal-priority )The level of importance associated with a goal. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Used for sorting and presenting goals. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
28. Goal.description | |||||
Definition | Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding". | ||||
Short | Code or text describing goal | ||||
Comments | If no code is available, use CodeableConcept.text. | ||||
Control | 1..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from SNOMEDCTClinicalFindings (extensible to http://hl7.org/fhir/ValueSet/clinical-findings ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Without a description of what's trying to be achieved, element has no purpose. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
30. Goal.subject | |||||
Definition | Identifies the patient, group or organization for whom the goal is being established. | ||||
Short | Who this goal is intended for | ||||
Control | 1..1 | ||||
Type | Reference(TW Core Patient, Group, TW Core Organization) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Must Support Types | Reference(TW Core Patient) | ||||
Summary | true | ||||
Requirements | Subject is optional to support annonymized reporting. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
32. Goal.start[x] | |||||
Definition | The date or event after which the goal should begin being pursued. | ||||
Short | When goal pursuit begins | ||||
Control | 0..1 | ||||
Binding | For example codes, see GoalStartEvent (example to http://hl7.org/fhir/ValueSet/goal-start-event )Codes describing events that can trigger the initiation of a goal. | ||||
Type | Choice of: date, CodeableConcept | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Must Support Types | date | ||||
Summary | true | ||||
Requirements | Goals can be established prior to there being an intention to start pursuing them; e.g. Goals for post-surgical recovery established prior to surgery. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
34. Goal.target | |||||
Definition | Indicates what should be done by when. | ||||
Short | Target outcome for the goal | ||||
Comments | When multiple targets are present for a single goal instance, all targets must be met for the overall goal to be met. | ||||
Control | 0..* This element is affected by the following invariants: gol-1 | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | false | ||||
Requirements | Allows the progress of the goal to be monitored against an observation or due date. Target is 0..* to support Observations with multiple components, such as blood pressure goals with both a systolic and diastolic target. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )gol-1: Goal.target.measure is required if Goal.target.detail is populated ( (detail.exists() and measure.exists()) or detail.exists().not() ) | ||||
36. Goal.target.id | |||||
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
38. Goal.target.extension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. | ||||
Short | Additional content defined by implementations | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
40. Goal.target.modifierExtension | |||||
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. | ||||
Alternate Names | extensions, user content, modifiers | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) )ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists() ) | ||||
42. Goal.target.measure | |||||
Definition | The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. | ||||
Short | The parameter whose value is being tracked | ||||
Control | 0..1 This element is affected by the following invariants: gol-1 | ||||
Binding | For example codes, see LOINCCodes (example to http://hl7.org/fhir/ValueSet/observation-codes )Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
44. Goal.target.detail[x] | |||||
Definition | The target value of the focus to be achieved to signify the fulfillment of the goal, e.g. 150 pounds, 7.0%. Either the high or low or both values of the range can be specified. When a low value is missing, it indicates that the goal is achieved at any focus value at or below the high value. Similarly, if the high value is missing, it indicates that the goal is achieved at any focus value at or above the low value. | ||||
Short | The target value to be achieved | ||||
Comments | A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Goal.target.measure defines a coded value. | ||||
Control | 0..1 This element is affected by the following invariants: gol-1 | ||||
Binding | Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal. | ||||
Type | Choice of: Quantity, Range, CodeableConcept, string, boolean, integer, Ratio | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
46. Goal.target.due[x] | |||||
Definition | Indicates either the date or the duration after start by which the goal should be met. | ||||
Short | Reach goal on or before | ||||
Control | 0..1 | ||||
Type | Choice of: date, Duration | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Must Support Types | date | ||||
Summary | true | ||||
Requirements | Identifies when the goal should be evaluated. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
48. Goal.statusDate | |||||
Definition | Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc. | ||||
Short | When goal status took effect | ||||
Comments | To see the date for past statuses, query history. | ||||
Control | 0..1 | ||||
Type | date | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
50. Goal.statusReason | |||||
Definition | Captures the reason for the current status. | ||||
Short | Reason for current status | ||||
Comments | This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others. | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
52. Goal.expressedBy | |||||
Definition | Indicates whose goal this is - patient goal, practitioner goal, etc. | ||||
Short | Who's responsible for creating Goal? | ||||
Comments | This is the individual responsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.). | ||||
Control | 0..1 | ||||
Type | Reference(TW Core Patient, TW Core Practitioner, TW Core PractitionerRole, TW Core RelatedPerson) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
54. Goal.addresses | |||||
Definition | The identified conditions and other health record elements that are intended to be addressed by the goal. | ||||
Short | Issues addressed by this goal | ||||
Control | 0..* | ||||
Type | Reference(TW Core Condition, TW Core Observation Clinical Result, TW Core MedicationStatement, NutritionOrder, TW Core ServiceRequest, RiskAssessment) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
56. Goal.note | |||||
Definition | Any comments related to the goal. | ||||
Short | Comments about the goal | ||||
Comments | May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself. | ||||
Control | 0..* | ||||
Type | Annotation | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | There's a need to capture information about the goal that doesn't actually describe the goal. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
58. Goal.outcomeCode | |||||
Definition | Identifies the change (or lack of change) at the point when the status of the goal is assessed. | ||||
Short | What result was achieved regarding the goal? | ||||
Comments | Note that this should not duplicate the goal status. | ||||
Control | 0..* | ||||
Binding | For example codes, see SNOMEDCTClinicalFindings (example to http://hl7.org/fhir/ValueSet/clinical-findings )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". | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Outcome tracking is a key aspect of care planning. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
60. Goal.outcomeReference | |||||
Definition | Details of what's changed (or not changed). | ||||
Short | Observation that resulted from goal | ||||
Comments | The goal outcome is independent of the outcome of the related activities. For example, if the Goal is to achieve a target body weight of 150 lb and a care plan activity is defined to diet, then the care plan’s activity outcome could be calories consumed whereas goal outcome is an observation for the actual body weight measured. | ||||
Control | 0..* | ||||
Type | Reference(TW Core Observation Clinical Result) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Requirements | Outcome tracking is a key aspect of care planning. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |