Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: HCIM TreatmentObjective

TreatmentObjective as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 3.1, release 2017. The treatment objective describes the desired result of the treatment/interventions in terms of the patient’s diagnosed problem. The objective and target date are entered in addition to the target value. Comparing the healthcare results to the treatment objective provides insight into the effectivity of the treatment/interventions.

A treatment objective is recorded to indicate the intention of the treatment/intervention. It provides an indication of the procedures to be carried out as part of the care process. This also enables us to monitor developments in the patient’s health condition for the desired healthcare result.

Usage:

• Refer to this Resource Profile: nl-core-careplan and HCIM NursingIntervention
• Examples for this Resource Profile: Goal/zib-treatmentobjective-01 and Goal/zib-treatmentobjective-02

Formal Views of Profile Content

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

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

This structure is derived from Goal

Name	Flags	Card.	Type	Description & Constraints
Goal		0..*	Goal	TreatmentObjective
identifier		0..*	Identifier	External Ids for this goal
description		1..1	CodeableConcept	DesiredHealthcareResult
subject		0..1	Reference(nl-core-patient | Group | nl-core-organization)	Who this goal is intended for
target
measure		0..1	CodeableConcept	The parameter whose value is being tracked
detail[x]		0..1	Quantity, Range, CodeableConcept	TargetValue / DesiredHealthCondition
expressedBy		0..1	Reference(nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who's responsible for creating Goal?
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
addresses		0..1	Reference(HCIM Problem | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessment)	Problem
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Goal		0..*	Goal	TreatmentObjective
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External Ids for this goal
status	?!Σ	1..1	code	proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected Binding: GoalStatus (required): Indicates whether the goal has been met and is still being targeted
description	Σ	1..1	CodeableConcept	DesiredHealthcareResult Binding: SNOMED CT Clinical Findings (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	0..1	Reference(nl-core-patient | Group | nl-core-organization)	Who this goal is intended for
expressedBy	Σ	0..1	Reference(nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who's responsible for creating Goal?
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
addresses		0..1	Reference(HCIM Problem | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessment)	Problem
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Goal.status	required	GoalStatus http://hl7.org/fhir/ValueSet/goal-status from the FHIR Standard
Goal.description	example	SNOMED CT Clinical Findings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Goal	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Goal	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Goal	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Goal	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()

Name	Flags	Card.	Type	Description & Constraints
Goal		0..*	Goal	TreatmentObjective
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: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External Ids for this goal
status	?!Σ	1..1	code	proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected Binding: GoalStatus (required): Indicates whether the goal has been met and is still being targeted
category	Σ	0..*	CodeableConcept	E.g. Treatment, dietary, behavioral, etc. Binding: GoalCategory (example): Codes for grouping and sorting goals
priority	Σ	0..1	CodeableConcept	high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal
description	Σ	1..1	CodeableConcept	DesiredHealthcareResult Binding: SNOMED CT Clinical Findings (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	0..1	Reference(nl-core-patient | Group | nl-core-organization)	Who this goal is intended for
start[x]	Σ	0..1		When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal
startDate			date
startCodeableConcept			CodeableConcept
target	C	0..1	BackboneElement	Target outcome for the goal gol-1: Goal.target.measure is required if Goal.target.detail is populated
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
measure	ΣC	0..1	CodeableConcept	The parameter whose value is being tracked Binding: LOINC Codes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
detail[x]	ΣC	0..1		TargetValue / DesiredHealthCondition Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.
detailQuantity			Quantity
detailRange			Range
detailCodeableConcept			CodeableConcept
due[x]	Σ	0..1		Reach goal on or before
dueDate			date
dueDuration			Duration
statusDate	Σ	0..1	date	When goal status took effect
statusReason		0..1	string	Reason for current status
expressedBy	Σ	0..1	Reference(nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who's responsible for creating Goal?
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
addresses		0..1	Reference(HCIM Problem | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessment)	Problem
note		0..*	Annotation	Comments about the goal
outcomeCode		0..*	CodeableConcept	What result was achieved regarding the goal? Binding: SNOMED CT Clinical Findings (example): The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months"
outcomeReference		0..*	Reference(Observation)	Observation that resulted from goal
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Goal.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Goal.status	required	GoalStatus http://hl7.org/fhir/ValueSet/goal-status from the FHIR Standard
Goal.category	example	GoalCategory http://hl7.org/fhir/ValueSet/goal-category from the FHIR Standard
Goal.priority	preferred	GoalPriority http://hl7.org/fhir/ValueSet/goal-priority from the FHIR Standard
Goal.description	example	SNOMED CT Clinical Findings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
Goal.start[x]	example	GoalStartEvent http://hl7.org/fhir/ValueSet/goal-start-event from the FHIR Standard
Goal.target.measure	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Goal.target.detail[x]	example
Goal.outcomeCode	example	SNOMED CT Clinical Findings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Goal	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Goal	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Goal	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Goal	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
gol-1	error	Goal.target	Goal.target.measure is required if Goal.target.detail is populated : (detail.exists() and measure.exists()) or detail.exists().not()

This structure is derived from Goal

Summary

Structures

This structure refers to these other structures:

• nl-core-patient (http://fhir.nl/fhir/StructureDefinition/nl-core-patient)
• nl-core-organization (http://fhir.nl/fhir/StructureDefinition/nl-core-organization)
• nl-core-practitioner (http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner)
• nl-core-relatedperson (http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson)
• HCIM Problem (http://nictiz.nl/fhir/StructureDefinition/zib-Problem)

Extensions

This structure refers to these extensions:

• http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference

Differential View

This structure is derived from Goal

Name	Flags	Card.	Type	Description & Constraints
Goal		0..*	Goal	TreatmentObjective
identifier		0..*	Identifier	External Ids for this goal
description		1..1	CodeableConcept	DesiredHealthcareResult
subject		0..1	Reference(nl-core-patient | Group | nl-core-organization)	Who this goal is intended for
target
measure		0..1	CodeableConcept	The parameter whose value is being tracked
detail[x]		0..1	Quantity, Range, CodeableConcept	TargetValue / DesiredHealthCondition
expressedBy		0..1	Reference(nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who's responsible for creating Goal?
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
addresses		0..1	Reference(HCIM Problem | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessment)	Problem
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Goal		0..*	Goal	TreatmentObjective
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External Ids for this goal
status	?!Σ	1..1	code	proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected Binding: GoalStatus (required): Indicates whether the goal has been met and is still being targeted
description	Σ	1..1	CodeableConcept	DesiredHealthcareResult Binding: SNOMED CT Clinical Findings (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	0..1	Reference(nl-core-patient | Group | nl-core-organization)	Who this goal is intended for
expressedBy	Σ	0..1	Reference(nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who's responsible for creating Goal?
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
addresses		0..1	Reference(HCIM Problem | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessment)	Problem
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Goal.status	required	GoalStatus http://hl7.org/fhir/ValueSet/goal-status from the FHIR Standard
Goal.description	example	SNOMED CT Clinical Findings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Goal	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Goal	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Goal	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Goal	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Goal		0..*	Goal	TreatmentObjective
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: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External Ids for this goal
status	?!Σ	1..1	code	proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected Binding: GoalStatus (required): Indicates whether the goal has been met and is still being targeted
category	Σ	0..*	CodeableConcept	E.g. Treatment, dietary, behavioral, etc. Binding: GoalCategory (example): Codes for grouping and sorting goals
priority	Σ	0..1	CodeableConcept	high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): The level of importance associated with a goal
description	Σ	1..1	CodeableConcept	DesiredHealthcareResult Binding: SNOMED CT Clinical Findings (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	0..1	Reference(nl-core-patient | Group | nl-core-organization)	Who this goal is intended for
start[x]	Σ	0..1		When goal pursuit begins Binding: GoalStartEvent (example): Codes describing events that can trigger the initiation of a goal
startDate			date
startCodeableConcept			CodeableConcept
target	C	0..1	BackboneElement	Target outcome for the goal gol-1: Goal.target.measure is required if Goal.target.detail is populated
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
measure	ΣC	0..1	CodeableConcept	The parameter whose value is being tracked Binding: LOINC Codes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
detail[x]	ΣC	0..1		TargetValue / DesiredHealthCondition Binding: (unbound) (example): Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal.
detailQuantity			Quantity
detailRange			Range
detailCodeableConcept			CodeableConcept
due[x]	Σ	0..1		Reach goal on or before
dueDate			date
dueDuration			Duration
statusDate	Σ	0..1	date	When goal status took effect
statusReason		0..1	string	Reason for current status
expressedBy	Σ	0..1	Reference(nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who's responsible for creating Goal?
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
addresses		0..1	Reference(HCIM Problem | Observation | MedicationStatement | NutritionOrder | ProcedureRequest | RiskAssessment)	Problem
note		0..*	Annotation	Comments about the goal
outcomeCode		0..*	CodeableConcept	What result was achieved regarding the goal? Binding: SNOMED CT Clinical Findings (example): The result of the goal; e.g. "25% increase in shoulder mobility", "Anxiety reduced to moderate levels". "15 kg weight loss sustained over 6 months"
outcomeReference		0..*	Reference(Observation)	Observation that resulted from goal
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Goal.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Goal.status	required	GoalStatus http://hl7.org/fhir/ValueSet/goal-status from the FHIR Standard
Goal.category	example	GoalCategory http://hl7.org/fhir/ValueSet/goal-category from the FHIR Standard
Goal.priority	preferred	GoalPriority http://hl7.org/fhir/ValueSet/goal-priority from the FHIR Standard
Goal.description	example	SNOMED CT Clinical Findings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
Goal.start[x]	example	GoalStartEvent http://hl7.org/fhir/ValueSet/goal-start-event from the FHIR Standard
Goal.target.measure	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Goal.target.detail[x]	example
Goal.outcomeCode	example	SNOMED CT Clinical Findings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-1	error	Goal	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Goal	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Goal	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Goal	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
gol-1	error	Goal.target	Goal.target.measure is required if Goal.target.detail is populated : (detail.exists() and measure.exists()) or detail.exists().not()

This structure is derived from Goal

Summary

Structures

This structure refers to these other structures:

• nl-core-patient (http://fhir.nl/fhir/StructureDefinition/nl-core-patient)
• nl-core-organization (http://fhir.nl/fhir/StructureDefinition/nl-core-organization)
• nl-core-practitioner (http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner)
• nl-core-relatedperson (http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson)
• HCIM Problem (http://nictiz.nl/fhir/StructureDefinition/zib-Problem)

Extensions

This structure refers to these extensions:

• http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference

Other representations of profile: CSV, Excel, Schematron