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pending Template  Goal Observation

Id 2.16.840.1.113883.10.20.22.4.121
ref
ccda-
 		Effective Date 2015‑08‑13
Status pending Under pre-publication review Version Label 2.1
Name GoalObservation Display Name Goal Observation
Description
This template represents a patient health goal. A Goal Observation template may have related components that are acts, encounters, observations, procedures, substance administrations, or supplies. A goal may be a patient or provider goal. If the author is set to the recordTarget (patient), this is a patient goal. If the author is set to a provider, this is a provider goal. If both patient and provider are set as authors, this is a negotiated goal. A goal usually has a related health concern and/or risk. A goal may have components consisting of other goals (milestones). These milestones are related to the overall goal through entryRelationships.
Context Parent nodes of template element with id 2.16.840.1.113883.10.20.22.4.121
Classification CDA Entry Level Template
Open/Closed Open (other than defined elements are allowed)
Used by / Uses
Used by 0 transactions and 3 templates, Uses 5 templates
Used by as Name Version
2.16.840.1.113883.10.20.22.2.10 Containment draft Plan of Treatment Section (V2) (2.1) 2019‑03‑16 08:54:08
2.16.840.1.113883.3.51.60.2.4.1 link draft BC CDA ClinicalDocumentDischargeSummary (V3) (2.1) 2019‑03‑19 14:15:51
2.16.840.1.113883.10.20.22.4.121 Containment pending Goal Observation (2.1) 2015‑08‑13
notice Circular reference found with 2.16.840.1.113883.10.20.22.4.121, please check
Uses as Name Version
2.16.840.1.113883.10.20.22.4.119 Containment pending Author Participation (2.1) 2015‑08‑13
2.16.840.1.113883.10.20.22.4.122 Containment pending Entry Reference (2.1) 2015‑08‑13
2.16.840.1.113883.10.20.22.4.143 Containment pending Priority Preference (2.1) 2015‑08‑13
2.16.840.1.113883.10.20.22.4.121 Containment pending Goal Observation (2.1) 2015‑08‑13
2.16.840.1.113883.10.20.22.4.115 Containment pending External Document Reference (2.1) 2014‑06‑09
Relationship Specialization: template 2.16.840.1.113883.10.12.303 CDA Observation (2005‑09‑07)
ref
ad1bbr-
Item DT Card Conf Description Label
cda:observation
(Goadotsion)
treetree @classCode
1 … 1 F OBS CONFdots0418
  SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6) (CONF:1098-30418).
treetree @moodCode
1 … 1 F GOL CONFdots0419
  SHALL contain exactly one [1..1] @moodCode="GOL" Goal (CodeSystem: ActMood urn:oid:2.16.840.1.113883.5.1001) (CONF:1098-30419).
treetree cda:templateId
II 1 … 1 M SHALL contain exactly one [1..1] templateId (CONF:1098-8583) such that it CONFdots8583
treeblank treetree @root
1 … 1 F 2.16.840.1.113883.10.20.22.4.121 CONFdots0512
  SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.121" (CONF:1098-10512).
treetree cda:id
II 1 … * SHALL contain at least one [1..*] id (CONF:1098-32332). CONFdots2332
treetree cda:code
CD 1 … 1 M SHALL contain exactly one [1..1] code, which SHOULD be selected from CodeSystem LOINC (urn:oid:2.16.840.1.113883.6.1) (CONF:1098-30784). CONFdots0784
treeblank treetree @codeSystem
CONF 1 … 1 F 2.16.840.1.113883.6.1 (LOINC)
treetree cda:statusCode
CS 1 … 1 M SHALL contain exactly one [1..1] statusCode (CONF:1098-32333). CONFdots2333
treeblank treetree @code
CONF 1 … 1 F active
treetree cda:effectiveTime
IVL_TS 0 … 1 R SHOULD contain zero or one [0..1] effectiveTime (CONF:1098-32335). CONFdots2335
treetree cda:value
0 … 1 MAY contain zero or one [0..1] value (CONF:1098-32743). CONFdots2743
treetree cda:author
1 … * M SHALL contain at least one [1..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1098-30995).

If the author is set to the recordTarget (patient), this is a patient goal. If the author is set to a provider, this is a provider goal. If both patient and provider are set as authors, this is a negotiated goal.
Contains 2.16.840.1.113883.10.20.22.4.119 Author Participation (2015‑08‑13) 		CONFdots0995
treeblank where [cda:templateId [@root = '2.16.840.1.113883.10.20.22.4.119']]
treetree cda:entryRelationship
0 … * The following entryRelationship represents the relationship between a Goal Observation and a Health Concern Act (Goal Observation REFERS TO Health Concern Act). As Health Concern Act is already defined in Health Concerns Section, rather than clone the whole Health Concern Act template, an Entry Reference may be used in entryRelationship to refer the template.
Contains 2.16.840.1.113883.10.20.22.4.122 Entry Reference (2015‑08‑13) 		CONFdots0701
treeblank where [@typeCode='REFR']
treeblank treetree @typeCode
1 … 1 F REFR CONFdots0702
  SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-30702).
treetree cda:entryRelationship
0 … * The following entryRelationship represents a planned component of the goal such as Planned Encounter (V2), Planned Observation (V2), Planned Procedure (V2), Planned Medication Activity (V2), Planned Supply (V2), Planned Act (V2) or Planned Immunization Activity. Because these entries are already described in the Interventions Section of the CDA document instance, rather than repeating the full content of the entries, the Entry Reference template may be used to reference the entries.
Contains 2.16.840.1.113883.10.20.22.4.122 Entry Reference (2015‑08‑13) 		CONFdots0704
treeblank where [@typeCode='COMP']
treeblank treetree @typeCode
1 … 1 F COMP CONFdots0705
  SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-30705).
treetree cda:entryRelationship
0 … 1 R The following entryRelationship represents the priority that the patient or a provider puts on the goal.
Contains 2.16.840.1.113883.10.20.22.4.143 Priority Preference (2015‑08‑13) 		CONFdots0785
treeblank where [cda:observation [cda:templateId [@root = '2.16.840.1.113883.10.20.22.4.143']]]
treeblank treetree @typeCode
1 … 1 F REFR CONFdots0786
  SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-30786).
treetree cda:entryRelationship
0 … * The following entryRelationship represents the relationship between two Goal Observations where the target is a component of the source (Goal Observation HAS COMPONENT Goal Observation). The component goal (target) is a Milestone.
Contains 2.16.840.1.113883.10.20.22.4.121 Goal Observation (2015‑08‑13) 		CONFdots1448
treeblank where [cda:observation [cda:templateId [@root = '2.16.840.1.113883.10.20.22.4.121']]]
treeblank treetree @typeCode
1 … 1 F COMP CONFdots1449
  SHALL contain exactly one [1..1] @typeCode="COMP" Has component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31449).
treetree cda:entryRelationship
0 … * Where a Goal Observation needs to reference another entry already described in the CDA document instance, rather than repeating the full content of the entry, the Entry Reference template may be used to reference this entry.
Contains 2.16.840.1.113883.10.20.22.4.122 Entry Reference (2015‑08‑13) 		CONFdots1559
treeblank where [cda:act [cda:templateId [@root = '2.16.840.1.113883.10.20.22.4.122']]]
treeblank treetree @typeCode
1 … 1 F REFR CONFdots1560
  SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-31560).
treetree cda:reference
0 … * Where it is necessary to reference an external clinical document such a Referral document, Discharge Summary document etc., the External Document Reference template can be used to reference this document. However, if this Care Plan document is replacing or appending another Care Plan document in the same set, that relationship is set in the header, using ClinicalDocument/relatedDocument.
Contains 2.16.840.1.113883.10.20.22.4.115 External Document Reference (2014‑06‑09) 		CONFdots2754
treeblank where [cda:externalDocument [cda:templateId [@root = '2.16.840.1.113883.10.20.22.4.115'] [@extension = '2014-06-09']]]
treeblank treetree @typeCode
1 … 1 F REFR CONFdots2755
  The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1098-32755).