# US Core Goal Profile - US Core Implementation Guide v9.0.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **US Core Goal Profile**

## Resource Profile: US Core Goal Profile 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal | *Version*:9.0.0 | |
| * Standards status: *[Trial-use](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](changes-between-versions.md#us-core-maturity-levels): 5 | *Computable Name*:USCoreGoalProfile |
| *Other Identifiers:*OID:2.16.840.1.113883.4.642.40.2.42.28 | | |

 
The US Core Goal Profile inherits from the FHIR [Goal](https://hl7.org/fhir/R4/goal.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Goal resource to record, search, and fetch Goal information associated with a patient. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption. 

**Example Usage Scenarios:**

The following are example usage scenarios for this profile:

* Query for a Patient's Goals
* [Record or update](us-core-roadmap.md#future-candidate-requirements-under-consideration) a Patient's Goals

### Mandatory and Must Support Data Elements

The following data elements must always be present ([Mandatory](must-support.md) definition) or must be supported if the data is present in the sending system ([Must Support](must-support.md) definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The [Formal Views](#profile) below provides the formal summary, definitions, and terminology requirements.

**Each Goal Must Have:**

1. a status
1. description of the goal1
1. a patient

**Each Goal Must Support:**

1. start date2
1. target date(s)2
1. who established the goal3

1,2,3 see guidance below

### Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

* 2 Although both `Goal.startDate` and `Goal.target.dueDate` are marked as Must Support, the Server system is not required to support both, but **SHALL** support at least one of these elements.[§](requirements.md#CONF-0387) The Client application **SHALL** support both elements.[§](requirements.md#CONF-0388),[§](requirements.md#CONF-0389)
* 1 When exchanging Social Determinants of Health (SDOH) data, implementers **SHOULD** use the [Social Determinants of Health Goals](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1247.71/expansion) set which is curated by the Gravity Project to represent goals for all SDOH Domains.[§](requirements.md#CONF-0903)
* 1 Goals are often captured as text and communicated in `Goal.description.text`.
* See the [Screening and Assessments](screening-and-assessments.md) guidance page for more information when exchanging Social Determinants of Health (SDOH) Goals

* 3The profile element `Goal.expressedBy` communicates the [individual level provenance](basic-provenance.md#individual-level-provenance) author data corresponding to the U.S. Core Data for Interoperability (USCDI) Provenance Author Data Elements.

**Usages:**

* Examples for this Profile: [Goal/goal-1](Goal-goal-1.md) and [Goal/goal-sdoh-2](Goal-goal-sdoh-2.md)
* CapabilityStatements using this Profile: [US Core Client CapabilityStatement](CapabilityStatement-us-core-client.md) and [US Core Server CapabilityStatement](CapabilityStatement-us-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/hl7.fhir.us.core|current/StructureDefinition/StructureDefinition-us-core-goal.json)

**Changes since version 8.0.1:**

* The resource metadata has changed (copyright)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-us-core-goal.csv), [Excel](StructureDefinition-us-core-goal.xlsx), [Schematron](StructureDefinition-us-core-goal.sch) 

### Notes:

-------

**Quick Start**  

-------

Below is an overview of the required Server RESTful FHIR interactions for this profile - for example, search and read operations - when supporting the US Core interactions to access this profile's information (Profile Support + Interaction Support). Note that systems that support only US Core Profiles (Profile Only Support) are not required to support these interactions. See the [US Core Server CapabilityStatement](CapabilityStatement-us-core-server.md) for a complete list of supported RESTful interactions for this IG.

* See the [Scopes Format](scopes.md#scopes-format) section for a description of the SMART scopes syntax.
* See the [Search Syntax](general-guidance.md#search-syntax) section for a description of the US Core search syntax.
* See the [General Requirements](general-requirements.md) section for additional rules and expectations when a Server requires status parameters.
* See the [General Guidance](general-guidance.md) section for additional guidance on searching for multiple patients.

#### US Core Scopes

Servers providing access to goal data **SHALL** support these [US Core SMART Scopes](scopes.md#smart-scopes):

* [resource level scopes](http://hl7.org/fhir/smart-app-launch/STU2.2/scopes-and-launch-context.html#scopes-for-requesting-clinical-data): `<patient|user|system>/Goal.rs` [§](requirements.md#CONF-0141)

-------

#### Mandatory Search Parameters:

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

1. **SHALL** support searching for all goals for a patient using the [patient](SearchParameter-us-core-goal-patient.md) search parameter`GET [base]/Goal?patient={Patient/}[id]`Example:
> 
1. GET [base]/Goal?patient=Patient/1137192

**Implementation Notes**: Fetches a bundle of all US Core Goal Profile resources for the specified patient ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference)).

#### Optional Search Parameters:

The following search parameters and search parameter combinations **SHOULD** be supported

1. **SHOULD** support searching for all goals for a patient for a given status (for example active goals) using the combination of the [patient](SearchParameter-us-core-goal-patient.md) and [lifecycle-status](SearchParameter-us-core-goal-lifecycle-status.md) search parameters`GET [base]/Goal?patient={Patient/}[id]&lifecycle-status={system|}[search_code]`Example:
> 
1. GET [base]/Goal?patient=Patient/1137192&lifecycle-status=active

**Implementation Notes**: Fetches a bundle of all US Core Goal Profile resources for the specified patient and lifecycle-status ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token)).
1. **SHOULD** support searching for all goals for a patient by date using the combination of the [patient](SearchParameter-us-core-goal-patient.md) and [target-date](SearchParameter-us-core-goal-target-date.md) search parameters
* Including optional support for **AND** search on `target-date` (e.g.`target-date=[date]&target-date=[date]&...`)
* Including support for these `target-date` comparators: "gt", "lt", "ge", "le"
`GET [base]/Goal?patient={Patient/}[id]&target-date={gt|lt|ge|le}[dateTime]{&date={gt|lt|ge|le}[dateTime]&...}`Example:
> 
1. GET [base]/Goal?patient=Patient/1137192&target-date=ge2015-01-14&target-date=le2019-01-14

**Implementation Notes**: Fetches a bundle of all US Core Goal Profile resources for the specified patient and target-date ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by date](http://hl7.org/fhir/R4/search.html#date)).
1. **SHOULD** support searching for all goals for a patient by date using the combination of the [patient](SearchParameter-us-core-goal-patient.md) and [description](SearchParameter-us-core-goal-description.md) search parameters`GET [base]/Goal?patient={Patient/}[id]&description={system|}[search_code]`Example:
> 
1. GET [base]/Goal?patient=Patient/1137192&description=http://snomed.info/sct|1078229009

**Implementation Notes**: Fetches a bundle of all US Core Goal Profile resources for the specified patient and description ( see [how to search by reference](http://hl7.org/fhir/R4/search.html#reference) and [how to search by token](http://hl7.org/fhir/R4/search.html#token)).



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-core-goal",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 5
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cgp"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/core/ImplementationGuide/hl7.fhir.us.core"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-goal",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.40.2.42.28"
  }],
  "version" : "9.0.0",
  "name" : "USCoreGoalProfile",
  "title" : "US Core Goal Profile",
  "status" : "active",
  "experimental" : false,
  "date" : "2023-10-17",
  "publisher" : "HL7 International / Cross-Group Projects",
  "contact" : [{
    "name" : "HL7 International / Cross-Group Projects",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/cgp"
    },
    {
      "system" : "email",
      "value" : "cgp@lists.HL7.org"
    }]
  }],
  "description" : "The US Core Goal Profile inherits from the FHIR [Goal](https://hl7.org/fhir/R4/goal.html) resource; refer to it for scope and usage definitions. This profile sets minimum expectations for the Goal resource to record,  search, and fetch Goal information associated with a patient.   It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Goal",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Goal",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Goal",
      "path" : "Goal",
      "mustSupport" : false
    },
    {
      "id" : "Goal.lifecycleStatus",
      "path" : "Goal.lifecycleStatus",
      "mustSupport" : true,
      "binding" : {
        "strength" : "required",
        "valueSet" : "http://hl7.org/fhir/ValueSet/goal-status"
      }
    },
    {
      "id" : "Goal.description",
      "path" : "Goal.description",
      "mustSupport" : true,
      "binding" : {
        "strength" : "preferred",
        "description" : "Value set to describe the Goal",
        "valueSet" : "http://hl7.org/fhir/us/core/ValueSet/us-core-goal-description"
      }
    },
    {
      "id" : "Goal.subject",
      "path" : "Goal.subject",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
        "http://hl7.org/fhir/StructureDefinition/Group",
        "http://hl7.org/fhir/StructureDefinition/Organization"],
        "_targetProfile" : [{
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : true
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        }]
      }],
      "mustSupport" : true
    },
    {
      "id" : "Goal.start[x]",
      "path" : "Goal.start[x]",
      "type" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
          "valueBoolean" : true
        }],
        "code" : "date"
      },
      {
        "code" : "CodeableConcept"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Goal.target",
      "path" : "Goal.target",
      "mustSupport" : true
    },
    {
      "id" : "Goal.target.due[x]",
      "path" : "Goal.target.due[x]",
      "type" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
          "valueBoolean" : true
        }],
        "code" : "date"
      },
      {
        "code" : "Duration"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Goal.expressedBy",
      "path" : "Goal.expressedBy",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient",
        "http://hl7.org/fhir/StructureDefinition/PractitionerRole",
        "http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson"],
        "_targetProfile" : [{
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : true
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        },
        {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/elementdefinition-type-must-support",
            "valueBoolean" : false
          }]
        }]
      }],
      "mustSupport" : true
    }]
  }
}

```
