Implementierungsleitfaden Therapieziele Onkologie
1.0.0-ballot - Ballot Germany

Implementierungsleitfaden Therapieziele Onkologie - Local Development build (v1.0.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Ressourcenprofil: Onkologisches Therapieziel - Detaillierte Beschreibungen

Draft Stand: 2026-08-03

Definitionen für das onko-therapy-goal ressourcenprofil

Guidance on how to interpret the contents of this table can be foundhere

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.

ShortDescribes 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.

Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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.

ShortA 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.

Control0..1
Typeuri
Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Goal.extension
Definition

An Extension


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.

ShortExtensionAdditional 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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-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())
SlicingThis element introduces a set of slices on Goal.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Goal.extension:therapyIntent
    Slice NametherapyIntent
    Definition

    Strukturierte Therapieintention – Hauptintention und optionale Behandlungsphase.

    ShortTherapieintention
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Onkologische Therapieintention (Extension)) (Complex Extension)
    Is Modifierfalse
    Invariantsele-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())
    8. Goal.extension:acceptance
    Slice Nameacceptance
    Definition

    Akzeptanz und relative Priorität des Ziels durch Patient und Behandler – MCC goal-acceptance.

    ShortZielakzeptanz
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Goal acceptance) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-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())
    10. Goal.extension:reasonRejected
    Slice NamereasonRejected
    Definition

    Begründung, warum das Ziel nicht akzeptiert bzw. abgelehnt wurde.

    ShortAblehnungsgrund
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Goal Reason Rejected) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Goal.extension:relatedGoal
    Slice NamerelatedGoal
    Definition

    Beziehung zu anderen Zielen – predecessor, successor, replacement, milestone.

    ShortZielbeziehung
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Goal: Related Goal) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-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())
    14. 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).

    ShortExtensions 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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    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 Namesextensions, user content
    Invariantsele-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.lifecycleStatus
    Definition

    Status des Ziels im Lebenszyklus, z. B. proposed, active, completed, rejected.


    The state of the goal throughout its lifecycle.

    ShortLebenszyklus-Statusproposed | 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.

    Control1..1
    BindingThe 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.

    Typecode
    Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Allows knowing whether goal needs to be further tracked.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Goal.achievementStatus
    Definition

    Grad der Zielerreichung, z. B. erreicht, in Bearbeitung, nicht erreicht.


    Describes the progression, or lack thereof, towards the goal against the target.

    ShortErreichungsgradin-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
    Control0..1
    BindingThe codes SHOULD be taken from GoalAchievementStatushttp://hl7.org/fhir/ValueSet/goal-achievement|4.0.1
    (preferred to http://hl7.org/fhir/ValueSet/goal-achievement|4.0.1)

    Indicates the progression, or lack thereof, towards the goal against the target.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. Goal.category
    Definition

    Art des onkologischen Therapieziels – Heilung, Lebensverlängerung, Symptomkontrolle, Lebensqualität, Funktionserhalt.


    Indicates a category the goal falls within.

    ShortZielartE.g. Treatment, dietary, behavioral, etc.
    Control10..*
    BindingUnless not suitable, these codes SHALL be taken from For example codes, see Onkologische Therapieziel-Art (VS)http://hl7.org/fhir/ValueSet/goal-category|4.0.1
    (extensible to https://bih-cei.de/fhir/therapieziele-onkologie/ValueSet/onko-therapy-goal-type)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Allows goals to be filtered and sorted.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Goal.priority
    Definition

    Relative Priorität des Ziels bei mehreren konkurrierenden Zielen.


    Identifies the mutually agreed level of importance associated with reaching/sustaining the goal.

    ShortPrioritäthigh-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".

    Control0..1
    BindingThe codes SHOULD be taken from GoalPriorityhttp://hl7.org/fhir/ValueSet/goal-priority|4.0.1
    (preferred to http://hl7.org/fhir/ValueSet/goal-priority|4.0.1)

    The level of importance associated with a goal.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Used for sorting and presenting goals.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Goal.description
    Definition

    Klartext-Beschreibung des angestrebten Ziels.


    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".

    ShortZielbeschreibungCode or text describing goal
    Comments

    If no code is available, use CodeableConcept.text.

    Control1..1
    BindingFor example codes, see SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findings|4.0.1
    (example to http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1)

    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.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Without a description of what's trying to be achieved, element has no purpose.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Goal.subject
    Definition

    Person, für die das Therapieziel gilt.


    Identifies the patient, group or organization for whom the goal is being established.

    ShortPatientin/PatientWho this goal is intended for
    Control1..1
    TypeReference(Patient, Patient, Group, Organization)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Subject is optional to support annonymized reporting.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Goal.start[x]
    Definition

    Beginn des angestrebten Ziels als Datum oder codiertes Ereignis.


    The date or event after which the goal should begin being pursued.

    ShortZielbeginnWhen goal pursuit begins
    Control0..1
    BindingFor example codes, see GoalStartEventhttp://hl7.org/fhir/ValueSet/goal-start-event|4.0.1
    (example to http://hl7.org/fhir/ValueSet/goal-start-event|4.0.1)

    Codes describing events that can trigger the initiation of a goal.

    TypeChoice of: date, CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summarytrue
    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.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Goal.start[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
    • type @ $this
    • 30. Goal.start[x]:startDate
      Slice NamestartDate
      Definition

      Beginn des Ziels als Datum.


      The date or event after which the goal should begin being pursued.

      ShortZielbeginn als DatumWhen goal pursuit begins
      Control0..1
      Typedate, CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Goal.start[x]:startCodeableConcept
      Slice NamestartCodeableConcept
      Definition

      Beginn des Ziels als codiertes Ereignis.


      The date or event after which the goal should begin being pursued.

      ShortZielbeginn als CodeWhen goal pursuit begins
      Control0..1
      BindingFor example codes, see GoalStartEventhttp://hl7.org/fhir/ValueSet/goal-start-event|4.0.1
      (example to http://hl7.org/fhir/ValueSet/goal-start-event|4.0.1)

      Codes describing events that can trigger the initiation of a goal.

      TypeCodeableConcept, date
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      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.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Goal.target
      Definition

      Angestrebter messbarer Zielzustand.


      Indicates what should be done by when.

      ShortZielwertTarget 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.

      Control0..*
      This element is affected by the following invariants: gol-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      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.

      Invariantsele-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())
      36. 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).

      ShortExtensions 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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      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 Namesextensions, user content, modifiers
      Invariantsele-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())
      38. Goal.target.measure
      Definition

      Parameter bzw. Messgröße, an der die Zielerreichung gemessen wird.


      The parameter whose value is being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

      ShortZielparameterThe parameter whose value is being tracked
      Control0..1
      This element is affected by the following invariants: gol-1
      BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
      (example to http://hl7.org/fhir/ValueSet/observation-codes|4.0.1)

      Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. Goal.target.detail[x]
      Definition

      Angestrebter Wert bzw. Wertebereich des Zielparameters.


      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.

      ShortZielwert-AusprägungThe 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.

      Control0..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.

      TypeChoice of: Quantity, Range, CodeableConcept, string, boolean, integer, Ratio
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. Goal.target.due[x]
      Definition

      Zeitpunkt bzw. Frist, bis zu der das Ziel erreicht werden soll.


      Indicates either the date or the duration after start by which the goal should be met.

      ShortZielterminReach goal on or before
      Control0..1
      TypeChoice of: date, Duration
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      Identifies when the goal should be evaluated.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Goal.expressedBy
      Definition

      Person, die das Ziel formuliert hat – Behandler oder Patient.


      Indicates whose goal this is - patient goal, practitioner goal, etc.

      ShortVerfasserWho'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.).

      Control0..1
      TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Goal.addresses
      Definition

      Referenz auf die adressierte Tumorerkrankung OnkoCondition.


      The identified conditions and other health record elements that are intended to be addressed by the goal.

      ShortAdressierte ErkrankungIssues addressed by this goal
      Control0..*
      TypeReference(Onkologische Diagnose (Condition), Condition, Observation, MedicationStatement, NutritionOrder, ServiceRequest, RiskAssessment)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. Goal.note
      Definition

      Ergänzende Anmerkungen zum Ziel.


      Any comments related to the goal.

      ShortHinweisComments about the goal
      Comments

      May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.

      Control0..*
      TypeAnnotation
      Is Modifierfalse
      Summaryfalse
      Requirements

      There's a need to capture information about the goal that doesn't actually describe the goal.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. Goal.outcomeCode
      Definition

      Codiertes Ergebnis der Zielverfolgung.


      Identifies the change (or lack of change) at the point when the status of the goal is assessed.

      ShortErgebnis-CodeWhat result was achieved regarding the goal?
      Comments

      Note that this should not duplicate the goal status.

      Control0..*
      BindingFor example codes, see SNOMEDCTClinicalFindingshttp://hl7.org/fhir/ValueSet/clinical-findings|4.0.1
      (example to http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1)

      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".

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Requirements

      Outcome tracking is a key aspect of care planning.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. Goal.outcomeReference
      Definition

      Referenz auf Verlaufs-Observations, die das Tumoransprechen dokumentieren.


      Details of what's changed (or not changed).

      ShortErgebnis-ReferenzObservation 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.

      Control0..*
      TypeReference(Observation)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Outcome tracking is a key aspect of care planning.

      Invariantsele-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 foundhere

      0. Goal
      2. Goal.extension
      SlicingThis element introduces a set of slices on Goal.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 4. Goal.extension:therapyIntent
        Slice NametherapyIntent
        Definition

        Strukturierte Therapieintention – Hauptintention und optionale Behandlungsphase.

        ShortTherapieintention
        Control0..1
        TypeExtension(Onkologische Therapieintention (Extension)) (Complex Extension)
        6. Goal.extension:acceptance
        Slice Nameacceptance
        Definition

        Akzeptanz und relative Priorität des Ziels durch Patient und Behandler – MCC goal-acceptance.

        ShortZielakzeptanz
        Control0..*
        TypeExtension(Goal acceptance) (Complex Extension)
        Must Supporttrue
        8. Goal.extension:reasonRejected
        Slice NamereasonRejected
        Definition

        Begründung, warum das Ziel nicht akzeptiert bzw. abgelehnt wurde.

        ShortAblehnungsgrund
        Control0..1
        TypeExtension(Goal Reason Rejected) (Extension Type: CodeableConcept)
        Must Supporttrue
        10. Goal.extension:relatedGoal
        Slice NamerelatedGoal
        Definition

        Beziehung zu anderen Zielen – predecessor, successor, replacement, milestone.

        ShortZielbeziehung
        Control0..*
        TypeExtension(Goal: Related Goal) (Complex Extension)
        Must Supporttrue
        12. Goal.lifecycleStatus
        Definition

        Status des Ziels im Lebenszyklus, z. B. proposed, active, completed, rejected.

        ShortLebenszyklus-Status
        Must Supporttrue
        14. Goal.achievementStatus
        Definition

        Grad der Zielerreichung, z. B. erreicht, in Bearbeitung, nicht erreicht.

        ShortErreichungsgrad
        Must Supporttrue
        16. Goal.category
        Definition

        Art des onkologischen Therapieziels – Heilung, Lebensverlängerung, Symptomkontrolle, Lebensqualität, Funktionserhalt.

        ShortZielart
        Control1..?
        BindingUnless not suitable, these codes SHALL be taken from Onkologische Therapieziel-Art (VS)
        (extensible to https://bih-cei.de/fhir/therapieziele-onkologie/ValueSet/onko-therapy-goal-type)
        Must Supporttrue
        18. Goal.priority
        Definition

        Relative Priorität des Ziels bei mehreren konkurrierenden Zielen.

        ShortPriorität
        Must Supporttrue
        20. Goal.description
        Definition

        Klartext-Beschreibung des angestrebten Ziels.

        ShortZielbeschreibung
        Must Supporttrue
        22. Goal.subject
        Definition

        Person, für die das Therapieziel gilt.

        ShortPatientin/Patient
        TypeReference(Patient)
        Must Supporttrue
        24. Goal.start[x]
        Definition

        Beginn des angestrebten Ziels als Datum oder codiertes Ereignis.

        ShortZielbeginn
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Must Supporttrue
        SlicingThis element introduces a set of slices on Goal.start[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 26. Goal.start[x]:startDate
          Slice NamestartDate
          Definition

          Beginn des Ziels als Datum.

          ShortZielbeginn als Datum
          Control0..1
          Typedate
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          28. Goal.start[x]:startCodeableConcept
          Slice NamestartCodeableConcept
          Definition

          Beginn des Ziels als codiertes Ereignis.

          ShortZielbeginn als Code
          Control0..1
          TypeCodeableConcept
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          30. Goal.target
          Definition

          Angestrebter messbarer Zielzustand.

          ShortZielwert
          Must Supporttrue
          32. Goal.target.measure
          Definition

          Parameter bzw. Messgröße, an der die Zielerreichung gemessen wird.

          ShortZielparameter
          Must Supporttrue
          34. Goal.target.detail[x]
          Definition

          Angestrebter Wert bzw. Wertebereich des Zielparameters.

          ShortZielwert-Ausprägung
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          36. Goal.target.due[x]
          Definition

          Zeitpunkt bzw. Frist, bis zu der das Ziel erreicht werden soll.

          ShortZieltermin
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Must Supporttrue
          38. Goal.expressedBy
          Definition

          Person, die das Ziel formuliert hat – Behandler oder Patient.

          ShortVerfasser
          Must Supporttrue
          40. Goal.addresses
          Definition

          Referenz auf die adressierte Tumorerkrankung OnkoCondition.

          ShortAdressierte Erkrankung
          TypeReference(Onkologische Diagnose (Condition))
          Must Supporttrue
          42. Goal.note
          Definition

          Ergänzende Anmerkungen zum Ziel.

          ShortHinweis
          44. Goal.outcomeCode
          Definition

          Codiertes Ergebnis der Zielverfolgung.

          ShortErgebnis-Code
          46. Goal.outcomeReference
          Definition

          Referenz auf Verlaufs-Observations, die das Tumoransprechen dokumentieren.

          ShortErgebnis-Referenz
          Must Supporttrue

          Guidance on how to interpret the contents of this table can be foundhere

          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.

          ShortDescribes 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.

          Control0..*
          Is Modifierfalse
          Summaryfalse
          Invariantsdom-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.

          ShortLogical 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.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          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.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-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.

          ShortA 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.

          Control0..1
          Typeuri
          Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-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.

          ShortLanguage 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).

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-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.

          ShortText 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.

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-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.

          ShortContained, 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.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. Goal.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-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())
          SlicingThis element introduces a set of slices on Goal.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. Goal.extension:therapyIntent
            Slice NametherapyIntent
            Definition

            Strukturierte Therapieintention – Hauptintention und optionale Behandlungsphase.

            ShortTherapieintention
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Onkologische Therapieintention (Extension)) (Complex Extension)
            Is Modifierfalse
            Invariantsele-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.extension:acceptance
            Slice Nameacceptance
            Definition

            Akzeptanz und relative Priorität des Ziels durch Patient und Behandler – MCC goal-acceptance.

            ShortZielakzeptanz
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(Goal acceptance) (Complex Extension)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-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())
            20. Goal.extension:reasonRejected
            Slice NamereasonRejected
            Definition

            Begründung, warum das Ziel nicht akzeptiert bzw. abgelehnt wurde.

            ShortAblehnungsgrund
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Goal Reason Rejected) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-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())
            22. Goal.extension:relatedGoal
            Slice NamerelatedGoal
            Definition

            Beziehung zu anderen Zielen – predecessor, successor, replacement, milestone.

            ShortZielbeziehung
            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension(Goal: Related Goal) (Complex Extension)
            Is Modifierfalse
            Must Supporttrue
            Invariantsele-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())
            24. 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).

            ShortExtensions 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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            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 Namesextensions, user content
            Invariantsele-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())
            26. 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.

            ShortExternal 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.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Summaryfalse
            Requirements

            Allows identification of the goal as it is known by various participating systems and in a way that remains consistent across servers.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Goal.lifecycleStatus
            Definition

            Status des Ziels im Lebenszyklus, z. B. proposed, active, completed, rejected.

            ShortLebenszyklus-Status
            Comments

            This element is labeled as a modifier because the lifecycleStatus contains codes that mark the resource as not currently valid.

            Control1..1
            BindingThe 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.

            Typecode
            Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Requirements

            Allows knowing whether goal needs to be further tracked.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. Goal.achievementStatus
            Definition

            Grad der Zielerreichung, z. B. erreicht, in Bearbeitung, nicht erreicht.

            ShortErreichungsgrad
            Control0..1
            BindingThe codes SHOULD be taken from GoalAchievementStatus
            (preferred to http://hl7.org/fhir/ValueSet/goal-achievement|4.0.1)

            Indicates the progression, or lack thereof, towards the goal against the target.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. Goal.category
            Definition

            Art des onkologischen Therapieziels – Heilung, Lebensverlängerung, Symptomkontrolle, Lebensqualität, Funktionserhalt.

            ShortZielart
            Control1..*
            BindingUnless not suitable, these codes SHALL be taken from Onkologische Therapieziel-Art (VS)
            (extensible to https://bih-cei.de/fhir/therapieziele-onkologie/ValueSet/onko-therapy-goal-type)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Allows goals to be filtered and sorted.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Goal.priority
            Definition

            Relative Priorität des Ziels bei mehreren konkurrierenden Zielen.

            ShortPriorität
            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".

            Control0..1
            BindingThe codes SHOULD be taken from GoalPriority
            (preferred to http://hl7.org/fhir/ValueSet/goal-priority|4.0.1)

            The level of importance associated with a goal.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Used for sorting and presenting goals.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. Goal.description
            Definition

            Klartext-Beschreibung des angestrebten Ziels.

            ShortZielbeschreibung
            Comments

            If no code is available, use CodeableConcept.text.

            Control1..1
            BindingFor example codes, see SNOMEDCTClinicalFindings
            (example to http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1)

            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.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Without a description of what's trying to be achieved, element has no purpose.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. Goal.subject
            Definition

            Person, für die das Therapieziel gilt.

            ShortPatientin/Patient
            Control1..1
            TypeReference(Patient)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Subject is optional to support annonymized reporting.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. Goal.start[x]
            Definition

            Beginn des angestrebten Ziels als Datum oder codiertes Ereignis.

            ShortZielbeginn
            Control0..1
            BindingFor example codes, see GoalStartEvent
            (example to http://hl7.org/fhir/ValueSet/goal-start-event|4.0.1)

            Codes describing events that can trigger the initiation of a goal.

            TypeChoice of: date, CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summarytrue
            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.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Goal.start[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
            • type @ $this
            • 42. Goal.start[x]:startDate
              Slice NamestartDate
              Definition

              Beginn des Ziels als Datum.

              ShortZielbeginn als Datum
              Control0..1
              Typedate
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              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.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. Goal.start[x]:startCodeableConcept
              Slice NamestartCodeableConcept
              Definition

              Beginn des Ziels als codiertes Ereignis.

              ShortZielbeginn als Code
              Control0..1
              BindingFor example codes, see GoalStartEvent
              (example to http://hl7.org/fhir/ValueSet/goal-start-event|4.0.1)

              Codes describing events that can trigger the initiation of a goal.

              TypeCodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              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.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. Goal.target
              Definition

              Angestrebter messbarer Zielzustand.

              ShortZielwert
              Comments

              When multiple targets are present for a single goal instance, all targets must be met for the overall goal to be met.

              Control0..*
              This element is affected by the following invariants: gol-1
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              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.

              Invariantsele-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())
              48. 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.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              50. 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.

              ShortAdditional 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.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-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())
              52. 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).

              ShortExtensions 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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              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 Namesextensions, user content, modifiers
              Invariantsele-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())
              54. Goal.target.measure
              Definition

              Parameter bzw. Messgröße, an der die Zielerreichung gemessen wird.

              ShortZielparameter
              Control0..1
              This element is affected by the following invariants: gol-1
              BindingFor example codes, see LOINCCodes
              (example to http://hl7.org/fhir/ValueSet/observation-codes|4.0.1)

              Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. Goal.target.detail[x]
              Definition

              Angestrebter Wert bzw. Wertebereich des Zielparameters.

              ShortZielwert-Ausprägung
              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.

              Control0..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.

              TypeChoice of: Quantity, Range, CodeableConcept, string, boolean, integer, Ratio
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. Goal.target.due[x]
              Definition

              Zeitpunkt bzw. Frist, bis zu der das Ziel erreicht werden soll.

              ShortZieltermin
              Control0..1
              TypeChoice of: date, Duration
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summarytrue
              Requirements

              Identifies when the goal should be evaluated.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              60. Goal.statusDate
              Definition

              Identifies when the current status. I.e. When initially created, when achieved, when cancelled, etc.

              ShortWhen goal status took effect
              Comments

              To see the date for past statuses, query history.

              Control0..1
              Typedate
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              62. Goal.statusReason
              Definition

              Captures the reason for the current status.

              ShortReason for current status
              Comments

              This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              64. Goal.expressedBy
              Definition

              Person, die das Ziel formuliert hat – Behandler oder Patient.

              ShortVerfasser
              Comments

              This is the individual responsible for establishing the goal, not necessarily who recorded it. (For that, use the Provenance resource.).

              Control0..1
              TypeReference(Patient, Practitioner, PractitionerRole, RelatedPerson)
              Is Modifierfalse
              Must Supporttrue
              Must Support TypesNo must-support rules about the choice of types/profiles
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              66. Goal.addresses
              Definition

              Referenz auf die adressierte Tumorerkrankung OnkoCondition.

              ShortAdressierte Erkrankung
              Control0..*
              TypeReference(Onkologische Diagnose (Condition))
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. Goal.note
              Definition

              Ergänzende Anmerkungen zum Ziel.

              ShortHinweis
              Comments

              May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself.

              Control0..*
              TypeAnnotation
              Is Modifierfalse
              Summaryfalse
              Requirements

              There's a need to capture information about the goal that doesn't actually describe the goal.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              70. Goal.outcomeCode
              Definition

              Codiertes Ergebnis der Zielverfolgung.

              ShortErgebnis-Code
              Comments

              Note that this should not duplicate the goal status.

              Control0..*
              BindingFor example codes, see SNOMEDCTClinicalFindings
              (example to http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1)

              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".

              TypeCodeableConcept
              Is Modifierfalse
              Summaryfalse
              Requirements

              Outcome tracking is a key aspect of care planning.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              72. Goal.outcomeReference
              Definition

              Referenz auf Verlaufs-Observations, die das Tumoransprechen dokumentieren.

              ShortErgebnis-Referenz
              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.

              Control0..*
              TypeReference(Observation)
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Requirements

              Outcome tracking is a key aspect of care planning.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))