2026 US Quality Core Implementation Guide
0.5.0 - release United States of America flag

This page is part of the US Quality Core (v0.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: US Quality Core Goal

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-goal Version: 0.5.0
Active as of 2026-06-05 Computable Name: USQualityCoreGoal

Profile of Goal for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V1 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V1 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are tagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

  • description: (USCDI+ Quality) (USCDI) Code or text describing goal
  • target: (USCDI+ Quality) (USCDI) Target outcome for the goal

Because this profile is derived from US Core, systems are also expected to support Must Support requirements and (USCDI) tagged elements inherited from US Core. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile(6.1.0) Describes the intended objective(s) for a patient, group or organization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... lifecycleStatus ?!SΣ 1..1 code (USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who this goal is intended for
... start[x] SΣ 0..1 (USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date S
.... startCodeableConcept CodeableConcept
... target SC 0..* BackboneElement (USCDI+ Quality) (USCDI) Target outcome for the goal
Constraints: gol-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... due[x] SΣ 0..1 (USCDI) Reach goal on or before
..... dueDate date S
..... dueDuration Duration

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Goal.lifecycleStatus Base required GoalLifecycleStatus 📦4.0.1 FHIR Std.
Goal.description Base extensible US Core Goal Codes 📦7.0.0 US Core v7.0
Goal.start[x] Base preferred Goal start event 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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 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 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()
dom-5 error Goal If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Goal A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
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()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile(6.1.0) Describes the intended objective(s) for a patient, group or organization
... description 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code or text describing goal
... subject 1..1 Reference(US Quality Core Patient) (USCDI) Who this goal is intended for
... start[x] Σ 0..1 (USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date
.... startCodeableConcept CodeableConcept

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Goal.start[x] Base preferred Goal start event 📦4.0.1 FHIR Std.
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile(6.1.0) Describes the intended objective(s) for a patient, group or organization
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... 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
... lifecycleStatus ?!SΣ 1..1 code (USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.
... 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 SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who this goal is intended for
... start[x] SΣ 0..1 (USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date S
.... startCodeableConcept CodeableConcept
... target SC 0..* BackboneElement (USCDI+ Quality) (USCDI) Target outcome for the goal
Constraints: gol-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... measure ΣC 0..1 CodeableConcept The parameter whose value is being tracked
Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
.... detail[x] ΣC 0..1 The target value to be achieved
Binding Description: (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
..... detailString string
..... detailBoolean boolean
..... detailInteger integer
..... detailRatio Ratio
.... due[x] SΣ 0..1 (USCDI) Reach goal on or before
..... dueDate date S
..... 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(Patient | Practitioner | PractitionerRole | RelatedPerson) Who's responsible for creating Goal?
... addresses 0..* Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment) Issues addressed by this goal
... note 0..* Annotation Comments about the goal
... outcomeCode 0..* CodeableConcept What result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Goal.language Base preferred Common Languages 📦4.0.1 FHIR Std.
Goal.lifecycleStatus Base required GoalLifecycleStatus 📦4.0.1 FHIR Std.
Goal.achievementStatus Base preferred Goal achievement status 📦4.0.1 FHIR Std.
Goal.category Base example Goal category 📦4.0.1 FHIR Std.
Goal.priority Base preferred Goal priority 📦4.0.1 FHIR Std.
Goal.description Base extensible US Core Goal Codes 📦7.0.0 US Core v7.0
Goal.start[x] Base preferred Goal start event 📦4.0.1 FHIR Std.
Goal.target.measure Base example LOINC Codes 📦4.0.1 FHIR Std.
Goal.target.detail[x] Base example Not State Unknown
Goal.outcomeCode Base example SNOMED CT Clinical Findings 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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 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 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()
dom-5 error Goal If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Goal A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
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()

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile(6.1.0) Describes the intended objective(s) for a patient, group or organization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... lifecycleStatus ?!SΣ 1..1 code (USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who this goal is intended for
... start[x] SΣ 0..1 (USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date S
.... startCodeableConcept CodeableConcept
... target SC 0..* BackboneElement (USCDI+ Quality) (USCDI) Target outcome for the goal
Constraints: gol-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... due[x] SΣ 0..1 (USCDI) Reach goal on or before
..... dueDate date S
..... dueDuration Duration

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Goal.lifecycleStatus Base required GoalLifecycleStatus 📦4.0.1 FHIR Std.
Goal.description Base extensible US Core Goal Codes 📦7.0.0 US Core v7.0
Goal.start[x] Base preferred Goal start event 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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 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 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()
dom-5 error Goal If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Goal A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
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()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile(6.1.0) Describes the intended objective(s) for a patient, group or organization
... description 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code or text describing goal
... subject 1..1 Reference(US Quality Core Patient) (USCDI) Who this goal is intended for
... start[x] Σ 0..1 (USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date
.... startCodeableConcept CodeableConcept

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Goal.start[x] Base preferred Goal start event 📦4.0.1 FHIR Std.

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Goal 0..* USCoreGoalProfile(6.1.0) Describes the intended objective(s) for a patient, group or organization
... 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
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... 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
... lifecycleStatus ?!SΣ 1..1 code (USCDI) proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected
Binding: GoalLifecycleStatus (required)
... achievementStatus Σ 0..1 CodeableConcept in-progress | improving | worsening | no-change | achieved | sustaining | not-achieved | no-progress | not-attainable
Binding: GoalAchievementStatus (preferred): Indicates the progression, or lack thereof, towards the goal against the target.
... 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 SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code or text describing goal
Binding: US Core Goal Codes (extensible): Value set to describe the Goal
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who this goal is intended for
... start[x] SΣ 0..1 (USCDI) When goal pursuit begins
Binding: GoalStartEvent (preferred): Codes describing events that can trigger the initiation of a goal.
.... startDate date S
.... startCodeableConcept CodeableConcept
... target SC 0..* BackboneElement (USCDI+ Quality) (USCDI) Target outcome for the goal
Constraints: gol-1
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... measure ΣC 0..1 CodeableConcept The parameter whose value is being tracked
Binding: LOINCCodes (example): Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level.
.... detail[x] ΣC 0..1 The target value to be achieved
Binding Description: (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
..... detailString string
..... detailBoolean boolean
..... detailInteger integer
..... detailRatio Ratio
.... due[x] SΣ 0..1 (USCDI) Reach goal on or before
..... dueDate date S
..... 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(Patient | Practitioner | PractitionerRole | RelatedPerson) Who's responsible for creating Goal?
... addresses 0..* Reference(Condition | Observation | MedicationStatement | NutritionOrder | ServiceRequest | RiskAssessment) Issues addressed by this goal
... note 0..* Annotation Comments about the goal
... outcomeCode 0..* CodeableConcept What result was achieved regarding the goal?
Binding: SNOMEDCTClinicalFindings (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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Goal.language Base preferred Common Languages 📦4.0.1 FHIR Std.
Goal.lifecycleStatus Base required GoalLifecycleStatus 📦4.0.1 FHIR Std.
Goal.achievementStatus Base preferred Goal achievement status 📦4.0.1 FHIR Std.
Goal.category Base example Goal category 📦4.0.1 FHIR Std.
Goal.priority Base preferred Goal priority 📦4.0.1 FHIR Std.
Goal.description Base extensible US Core Goal Codes 📦7.0.0 US Core v7.0
Goal.start[x] Base preferred Goal start event 📦4.0.1 FHIR Std.
Goal.target.measure Base example LOINC Codes 📦4.0.1 FHIR Std.
Goal.target.detail[x] Base example Not State Unknown
Goal.outcomeCode Base example SNOMED CT Clinical Findings 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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 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 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()
dom-5 error Goal If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Goal A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
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()

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

 

Other representations of profile: CSV, Excel, Schematron