Goal
Overview
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.
This profile is used to define the content that will be returned by the API Server in response to requests to access Goal resources. All elements described in the Definition and Detailed Definitions below are supported, which means that the API Server is capable of supplying these fields from the product database when they have been populated via the product or its APIs.
This resource is referenced by: CarePlan.
List of profiles we support:
Definition
The official URL for this profile is:
https://fhir.athena.io/StructureDefinition/ah-goal
The base definition for this profile is:
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
  Goal | 0..* | Goal | 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.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
 Slices for extension | 1..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
 ahChartSharingGroup | 0..1 | Reference(Organization) | athenahealth Chart Sharing Group URL: https://fhir.athena.io/StructureDefinition/ah-chart-sharing-group | |||||
| ahPractice | 1..1 | Reference(Organization) | athenahealth Practice URL: https://fhir.athena.io/StructureDefinition/ah-practice | |||||
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| 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. | ||||
| priority | Σ | 0..1 | CodeableConcept | high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal. | ||||
| description | Σ | 1..1 | CodeableConcept | Code or text describing goal Binding: SNOMEDCTClinicalFindings (example): Codes providing the details of a particular goal. This will generally be system or implementation guide-specific. In many systems, only the text element will be used. | ||||
 subject | Σ | 1..1 | Reference(Patient | Group | Organization) | Who this goal is intended for | ||||
 target | C | 0..* | BackboneElement | Target outcome for the goal | ||||
 id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
 due[x] | Σ | 0..1 | date (YYYY-MM-DD) | Reach goal on or before | ||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Conformance | ValueSet | ||||
| Goal.language | preferred | CommonLanguages
| ||||
| Goal.lifecycleStatus | required | GoalLifecycleStatus | ||||
| Goal.achievementStatus | preferred | GoalAchievementStatus | ||||
| Goal.priority | preferred | GoalPriority | ||||
| Goal.description | example | SNOMEDCTClinicalFindings |
Detailed Definitions
Goal
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.
| Cardinality | 0..* |
| Type | Root |
| Comments | Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline. |
Goal.id
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
| Cardinality | 0..1 |
| Type | id |
| 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. |
Goal.meta
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.
| Cardinality | 0..1 |
| Type | Meta |
Goal.implicitRules
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.
| Cardinality | 0..1 |
| Type | uri |
| 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. |
Goal.language
The base language in which the resource is written.
| Cardinality | 0..1 |
| Type | code Binding: CommonLanguages (preferred) |
| 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). |
Goal.text
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.
| Cardinality | 0..1 |
| Type | Narrative |
| 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. |
Goal.contained
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.
| Cardinality | 0..* |
| Type | Resource |
| 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. |
Goal.extension:ahChartSharingGroup
An Extension used to reference a specific athenahealth chart sharing group Organization.
| Cardinality | 0..1 |
| Type | Extension(AthenaChartSharingGroup) |
Goal.extension:ahPractice
An Extension used to reference a specific athenahealth practice Organization.
| Cardinality | 1..1 |
| Type | Extension(AthenaPractice) |
Goal.modifierExtension
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).
| Cardinality | 0..* |
| Type | Extension |
| 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. |
| 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. |
Goal.identifier
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.
| Cardinality | 0..* |
| Type | Identifier |
| 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. |
| Requirements | Allows identification of the goal as it is known by various participating systems and in a way that remains consistent across servers. |
Goal.lifecycleStatus
The state of the goal throughout its lifecycle.
| Cardinality | 1..1 |
| Type | code Binding: GoalLifecycleStatus (required) |
| Comments | This element is labeled as a modifier because the lifecycleStatus contains codes that mark the resource as not currently valid. |
| Requirements | Allows knowing whether goal needs to be further tracked. |
Goal.achievementStatus
Describes the progression, or lack thereof, towards the goal against the target.
| Cardinality | 0..1 |
| Type | CodeableConcept Binding: GoalAchievementStatus (preferred) |
Goal.priority
Identifies the mutually agreed level of importance associated with reaching/sustaining the goal.
| Cardinality | 0..1 |
| Type | CodeableConcept Binding: GoalPriority (preferred) |
| 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". |
| Requirements | Used for sorting and presenting goals. |
Goal.description
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".
| Cardinality | 1..1 |
| Type | CodeableConcept Binding: SNOMEDCTClinicalFindings (example) |
| Comments | If no code is available, use CodeableConcept.text. |
| Requirements | Without a description of what's trying to be achieved, element has no purpose. |
Goal.subject
Identifies the patient, group or organization for whom the goal is being established.
| Cardinality | 1..1 |
| Type | Reference(Patient | Group | Organization) |
| Requirements | Subject is optional to support annonymized reporting. |
Goal.target
Indicates what should be done by when.
| Cardinality | 0..* |
| Type | BackboneElement |
| Comments | When multiple targets are present for a single goal instance, all targets must be met for the overall goal to be met. |
| 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. |
Goal.target.id
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
| Cardinality | 0..1 |
| Type | string |
Goal.target.extension
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.
| Cardinality | 0..* |
| Type | Extension |
| 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. |
Goal.target.modifierExtension
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).
| Cardinality | 0..* |
| Type | Extension |
| 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. |
| 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. |
Goal.target.due[x]
Indicates either the date or the duration after start by which the goal should be met.
| Cardinality | 0..1 |
| Type | date (YYYY-MM-DD) |
| Requirements | Identifies when the goal should be evaluated. |
Interactions
READ
Read interactions are executed as specified in the HL7 FHIR RESTful API read specification. To read Goal resources, an application will perform an HTTP GET specifying the logical ID of the Goal being retrieved.
The [patient|user|system]/Goal.read authorization scope is required.
Parameters
❙ required
❙ conditional required
| Name | Type | Description |
| logicalId | string | (REQUIRED) The logical ID of the resource (alias: Resource.id). It is specified in the URL path and not as a query parameter. |
Response Codes
| Response code | Description |
| 200 OK | The requested Goal resource was found and is contained within the body of the HTTP response. |
| 400 Bad Request | The server could not understand the request due to invalid syntax. The body of the HTTP response will contain an OperationOutcome resource that indicates the invalid request could not be processed. |
| 404 Not Found | The requested resource does not exist. The body of the HTTP response will contain an OperationOutcome resource that indicates the resource could not be found. |
| 410 Gone | The requested resource has been permanently deleted from server with no forwarding address. The body of the HTTP response will contain an OperationOutcome resource that indicates the resource could not be found. |
| 500 Internal Server Error | The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
| 5xx Server Error | The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
GET SEARCH
Search interactions are executed as specified in the HL7 FHIR RESTful API search specification. To search for Goal resources using the HTTP GET method, an application will perform the HTTP GET specifying the query parameters associated with the Goal in the URL.
The [patient|user|system]/Goal.read authorization scope is required.
The following additional authorization scopes might be required depending on _include and/or _revinclude search parameters used:
- [patient|user|system]/Organization.read
- [patient|user|system]/Patient.read
- [patient|user|system]/Provenance.read
Parameters
Goal search requests conditionally require one of the following search parameters or search parameter combinations in order to match and return a result set:- patient
- _id
❙ required
❙ conditional required
| Name | Type | Description |
| ah-practice | reference | Identify the athenahealth Practice Organization (e.g., 'ah-practice=Organization/a-1.Practice-[practiceId]') |
| patient | reference | (CONDITIONAL REQUIRED) Goal.patient resource reference to FHIR Patient resource |
| _count | number | The number of Goal resources to return per page for paged search results. |
| _id | token | (CONDITIONAL REQUIRED) Goal._id resource reference to FHIR Goal resource |
| cursor | token | Search by cursor token for first resource to return in a paged search result |
| ah-brand | reference | Search by athenahealth Brand (e.g., 'ah-brand=Organization/a-[practiceId].Brand-[brandId]') for resources containing the 'Athena Brand' Extension |
| ah-chart-sharing-group | reference | Search by athenahealth Chart Sharing Group (e.g., 'ah-chart-sharing-group=Organization/a-[practiceId].CSG-[csgId]') for resources containing the 'Athena Chart Sharing Group' Extension |
| ah-department | reference | Search by athenahealth Department (e.g., 'ah-department=Organization/a-[practiceId].Department-[deptId]') for resources containing the 'Athena Department' Extension |
| ah-provider-group | reference | Search by athenahealth Provider Group (e.g., 'ah-provider-group=Organization/a-[practiceId].PG-[providerGroupId]') for resources containing the 'Athena Provider Group' Extension |
| _include | string | Requests the server to include the referenced resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _include parameter values are:
|
| _revinclude | string | Requests the server to include the associated resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _revinclude parameter values are:
|
Response Codes
| Response code | Description |
| 200 OK | The search request succeeded. The body of the HTTP response will contain a Bundle resource containing the results of the search. |
| 403 Forbidden | The server refused to perform the search due to a missing required search parameter. The body of the HTTP response will contain an OperationOutcome resource that includes the required search parameters. |
| 500 Internal Server Error | The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
| 5xx Server Error | The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
POST SEARCH
Search interactions are executed as specified in the HL7 FHIR RESTful API search specification. To search for Goal resources using the HTTP POST method, an application will perform the HTTP POST specifying the query parameters associated with the Goal in the request body.
The [patient|user|system]/Goal.read authorization scope is required.
The following additional authorization scopes might be required depending on _include and/or _revinclude search parameters used:
- [patient|user|system]/Organization.read
- [patient|user|system]/Patient.read
- [patient|user|system]/Provenance.read
Request Header
Content-Type: application/x-www-form-urlencoded
Request Body
param1=value1¶m2=value2...
Parameters
Goal search requests conditionally require one of the following search parameters or search parameter combinations in order to match and return a result set:- patient
- _id
❙ required
❙ conditional required
| Name | Type | Description |
| ah-practice | reference | Identify the athenahealth Practice Organization (e.g., 'ah-practice=Organization/a-1.Practice-[practiceId]') |
| patient | reference | (CONDITIONAL REQUIRED) Goal.patient resource reference to FHIR Patient resource |
| _count | number | The number of Goal resources to return per page for paged search results. |
| _id | token | (CONDITIONAL REQUIRED) Goal._id resource reference to FHIR Goal resource |
| cursor | token | Search by cursor token for first resource to return in a paged search result |
| ah-brand | reference | Search by athenahealth Brand (e.g., 'ah-brand=Organization/a-[practiceId].Brand-[brandId]') for resources containing the 'Athena Brand' Extension |
| ah-chart-sharing-group | reference | Search by athenahealth Chart Sharing Group (e.g., 'ah-chart-sharing-group=Organization/a-[practiceId].CSG-[csgId]') for resources containing the 'Athena Chart Sharing Group' Extension |
| ah-department | reference | Search by athenahealth Department (e.g., 'ah-department=Organization/a-[practiceId].Department-[deptId]') for resources containing the 'Athena Department' Extension |
| ah-provider-group | reference | Search by athenahealth Provider Group (e.g., 'ah-provider-group=Organization/a-[practiceId].PG-[providerGroupId]') for resources containing the 'Athena Provider Group' Extension |
| _include | string | Requests the server to include the referenced resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _include parameter values are:
|
| _revinclude | string | Requests the server to include the associated resource(s) in the search results according to the specified search parameter. Additional authorization scope(s) will be required. The supported _revinclude parameter values are:
|
Response Codes
| Response code | Description |
| 200 OK | The search request succeeded. The body of the HTTP response will contain a Bundle resource containing the results of the search. |
| 403 Forbidden | The server refused to perform the search due to a missing required search parameter. The body of the HTTP response will contain an OperationOutcome resource that includes the required search parameters. |
| 500 Internal Server Error | The server has encountered a situation it doesn't know how to handle. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |
| 5xx Server Error | The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |