description: This template represents a patient health goal. A Goal Observation template may have related components that are acts, encounters, observations, procedures, substance administrations, or supplies. A goal identifies a future desired condition or state. Goals are often related to physical or mental health conditions or diseases, but also may be related to a Social Determinant of Health (SDOH) risks or states. For example, to have adequate quality meals and snacks, gain transportation security - able to access health and social needs). SDOH data relate to conditions in which people live, learn, work, and play and their effects on health risks and outcomes.  A Goal is established by the patient or provider. \n\nA goal may be a patient or provider goal. If the author is set to the recordTarget (patient), this is a patient goal. If the author is set to a provider, this is a provider goal. If both patient and provider are set as authors, this is a negotiated goal.\n\nA goal usually has a related health concern and/or risk.\n\nA goal may have components consisting of other goals (milestones). These milestones are related to the overall goal through entryRelationships.
package_name: hl7.cda.us.ccda
derivation: constraint
name: GoalObservation
type: http://hl7.org/cda/stds/core/StructureDefinition/Observation
elements:
  entryRelationship:
    index: 15
    slicing:
      rules: open
      discriminator:
      - {path: act, type: profile}
      - {path: observation, type: profile}
      - {path: typeCode, type: value}
      min: null
      slices:
        entryRelationship1:
          match: {typeCode: REFR}
          schema:
            short: The following entryRelationship represents the relationship between a Goal Observation and a Health Concern Act (Goal Observation REFERS TO Health Concern Act). As Health Concern Act is already defined in Health Concerns Section, rather than clone the whole Health Concern Act template, an Entry Reference may be used in entryRelationship to refer the template.
            array: true
            index: 16
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 17
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 18}
            required: [act]
        entryRelationship2:
          match: {typeCode: COMP}
          schema:
            short: The following entryRelationship represents a planned component of the goal such as Planned Encounter (V2), Planned Observation (V2), Planned Procedure (V2), Planned Medication Activity (V2), Planned Supply (V2), Planned Act (V2) or Planned Immunization Activity. Because these entries are already described in the Interventions Section of the CDA document instance, rather than repeating the full content of the entries, the Entry Reference template may be used to reference the entries.
            array: true
            index: 19
            elements:
              typeCode:
                pattern: {type: Code, value: COMP}
                index: 20
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 21}
            required: [act]
        entryRelationship3:
          match: {typeCode: REFR}
          schema:
            short: The following entryRelationship represents the priority that the patient or a provider puts on the goal.
            index: 22
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 23
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 24}
            required: [observation]
        entryRelationship4:
          match: {typeCode: COMP}
          schema:
            short: The following entryRelationship represents the relationship between two Goal Observations where the target is a component of the source (Goal Observation HAS COMPONENT Goal Observation). The component goal (target) is a Milestone.
            array: true
            index: 25
            elements:
              typeCode:
                pattern: {type: Code, value: COMP}
                index: 26
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', index: 27}
            required: [observation]
        entryRelationship5:
          match: {typeCode: REFR}
          schema:
            short: Where a Goal Observation needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
            array: true
            index: 28
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 29
              act: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Act', index: 30}
            required: [act]
        entryRelationship6:
          match: {typeCode: REFR}
          schema:
            short: entryRelationship
            array: true
            index: 31
            elements:
              typeCode:
                pattern: {type: Code, value: REFR}
                index: 32
              observation: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Observation', short: act, index: 33}
            required: [observation]
  value: {short: 'When the Goal is Social Determinant of Health Goal, the observation/value **SHOULD** be selected from ValueSet [Social Determinant of Health Goals](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1247.71/expansion) **DYNAMIC** (CONF:4515-32963).', index: 13}
  classCode:
    pattern: {type: Code, value: OBS}
    index: 4
  author: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/Author', short: 'If the author is the recordTarget (patient), this is a patient goal.  If the author is a provider, this is a provider goal. If both patient and provider are authors, this is a negotiated goal. If no author is present, it is assumed the document or section author(s) is the author of this goal.', index: 14}
  reference:
    short: Where it is necessary to reference an external clinical document such a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document.  However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
    index: 34
    elements:
      typeCode:
        pattern: {type: Code, value: REFR}
        index: 35
      externalDocument: {type: 'http://hl7.org/cda/stds/core/StructureDefinition/ExternalDocument', index: 36}
    required: [externalDocument]
  id: {index: 6}
  code: {short: 'When the Goal is a Social Determinant of Health Goal, use @code="8689-2" (History of Social function), @codeSystem="2.16.840.1.113883.6.1" (LOINC)', index: 7}
  moodCode:
    pattern: {type: Code, value: GOL}
    index: 5
  effectiveTime: {index: 12}
  templateId:
    index: 0
    slicing:
      rules: open
      discriminator:
      - {path: root, type: value}
      - {path: extension, type: value}
      min: 1
      slices:
        goal-obs:
          match: {root: 2.16.840.1.113883.10.20.22.4.121, extension: '2022-06-01'}
          schema:
            _required: true
            index: 1
            elements:
              root:
                pattern: {type: String, value: 2.16.840.1.113883.10.20.22.4.121}
                index: 2
              extension:
                pattern: {type: String, value: '2022-06-01'}
                index: 3
            required: [root, extension]
            extensions: {}
  statusCode:
    index: 10
    elements:
      code:
        binding: {strength: required, valueSet: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.15933'}
        index: 11
    required: [code]
  text:
    short: SHOULD reference the portion of section narrative text corresponding to this entry
    index: 8
    elements:
      reference:
        constraint:
          value-starts-octothorpe: {human: 'If reference/@value is present, it SHALL begin with a ''#'' and SHALL point to its corresponding narrative', source: 'http://hl7.org/cda/us/ccda/StructureDefinition/GoalObservation', severity: error, expression: value.exists() implies value.startsWith('#')}
        index: 9
package_version: 3.0.0-ballot
class: logical
kind: logical
url: http://hl7.org/cda/us/ccda/StructureDefinition/GoalObservation
base: http://hl7.org/cda/stds/core/StructureDefinition/Observation
version: 3.0.0-ballot
required: [id, statusCode, templateId]