<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="zib-TreatmentObjective" />
  <url value="http://nictiz.nl/fhir/StructureDefinition/zib-TreatmentObjective" />
  <version value="1.1.1" />
  <name value="Zib TreatmentObjective" />
  <title value="HCIM TreatmentObjective" />
  <status value="active" />
  <publisher value="Nictiz" />
  <contact>
    <name value="Nictiz" />
    <telecom>
      <system value="url" />
      <value value="https://www.nictiz.nl" />
      <use value="work" />
    </telecom>
  </contact>
  <description value="TreatmentObjective as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 3.1, release 2017. The treatment objective describes the desired result of the treatment/interventions in terms of the patient’s diagnosed problem. The objective and target date are entered in addition to the target value. Comparing the healthcare results to the treatment objective provides insight into the effectivity of the treatment/interventions." />
  <purpose value="A treatment objective is recorded to indicate the intention of the treatment/intervention. It provides an indication of the procedures to be carried out as part of the care process. This also enables us to monitor developments in the patient’s health condition for the desired healthcare result." />
  <copyright value="CC0" />
  <fhirVersion value="3.0.2" />
  <mapping>
    <identity value="hcim-treatmentobjective-v3.1-2017EN" />
    <uri value="https://zibs.nl/wiki/TreatmentObjective-v3.1(2017EN)" />
    <name value="HCIM TreatmentObjective-v3.1(2017EN)" />
  </mapping>
  <mapping>
    <identity value="hcim-basicelements-v1.0-2017EN" />
    <uri value="https://zibs.nl/wiki/BasicElements-v1.0(2017EN)" />
    <name value="HCIM BasicElements-v1.0(2017EN)" />
  </mapping>
  <kind value="resource" />
  <abstract value="false" />
  <type value="Goal" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Goal" />
  <derivation value="constraint" />
  <snapshot>
    <element id="Goal">
      <path value="Goal" />
      <short value="TreatmentObjective" />
      <definition value="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." />
      <comment value="Goal can be achieving a particular change or merely maintaining a current state or even slowing a decline." />
      <alias value="Behandeldoel" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Resource" />
        <min value="0" />
        <max value="*" />
      </base>
      <constraint>
        <key value="dom-2" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
        <expression value="contained.contained.empty()" />
        <xpath value="not(parent::f:contained and f:contained)" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-1" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL NOT contain any narrative" />
        <expression value="contained.text.empty()" />
        <xpath value="not(parent::f:contained and f:text)" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-4" />
        <severity value="error" />
        <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
        <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
        <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <constraint>
        <key value="dom-3" />
        <severity value="error" />
        <human value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource" />
        <expression value="contained.where(('#'+id in %resource.descendants().reference).not()).empty()" />
        <xpath value="not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))" />
        <source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="GOL.1" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode&lt;=OBJ]." />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="clinical.careprovision" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.1" />
        <comment value="TreatmentObjective" />
      </mapping>
    </element>
    <element id="Goal.id">
      <path value="Goal.id" />
      <short value="Logical id of this artifact" />
      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
      <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="id" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Goal.meta">
      <path value="Goal.meta" />
      <short value="Metadata about the resource" />
      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.meta" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Meta" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.implicitRules">
      <path value="Goal.implicitRules" />
      <short value="A set of rules under which this content was created" />
      <definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content." />
      <comment value="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. &#xA;&#xA;This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.implicitRules" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="uri" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Goal.language">
      <path value="Goal.language" />
      <short value="Language of the resource content" />
      <definition value="The base language in which the resource is written." />
      <comment value="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)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Resource.language" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueReference>
            <reference value="http://hl7.org/fhir/ValueSet/all-languages" />
          </valueReference>
        </extension>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language" />
        </extension>
        <strength value="extensible" />
        <description value="A human language." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/languages" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Goal.text">
      <path value="Goal.text" />
      <short value="Text summary of the resource, for human interpretation" />
      <definition value="A human-readable narrative that contains a summary of the resource, and may 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 &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
      <comment value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded in formation is added later." />
      <alias value="narrative" />
      <alias value="html" />
      <alias value="xhtml" />
      <alias value="display" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="DomainResource.text" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Narrative" />
      </type>
      <condition value="ele-1" />
      <condition value="dom-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act.text?" />
      </mapping>
    </element>
    <element id="Goal.contained">
      <path value="Goal.contained" />
      <short value="Contained, inline Resources" />
      <definition value="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." />
      <comment value="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." />
      <alias value="inline resources" />
      <alias value="anonymous resources" />
      <alias value="contained resources" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.contained" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Resource" />
      </type>
      <mapping>
        <identity value="rim" />
        <map value="Entity. Role, or Act" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.extension">
      <path value="Goal.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the resource. In order 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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.modifierExtension">
      <path value="Goal.modifierExtension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Extensions that cannot be ignored" />
      <definition value="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. Usually modifier elements provide negation or qualification. In order 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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="DomainResource.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.identifier">
      <path value="Goal.identifier" />
      <short value="External Ids for this goal" />
      <definition value="This records identifiers associated with this care plan that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation)." />
      <requirements value="Need to allow connection to a wider workflow." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Goal.identifier" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".id" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="id" />
      </mapping>
      <mapping>
        <identity value="hcim-basicelements-v1.0-2017EN" />
        <map value="NL-CM:0.0.6" />
        <comment value="IdentificationNumber" />
      </mapping>
    </element>
    <element id="Goal.status">
      <path value="Goal.status" />
      <short value="proposed | accepted | planned | in-progress | on-target | ahead-of-target | behind-target | sustaining | achieved | on-hold | cancelled | entered-in-error | rejected" />
      <definition value="Indicates whether the goal has been reached and is still considered relevant." />
      <comment value="This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid." />
      <requirements value="Allows measuring outcome and whether goal needs to be further tracked." />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Goal.status" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="code" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="GoalStatus" />
        </extension>
        <strength value="required" />
        <description value="Indicates whether the goal has been met and is still being targeted" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/goal-status" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="GOL-18-goal life cycle status" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".statusCode in-progress = active (classCode = OBJ) achieved = complete sustaining = active (classCode=OBJC) cancelled = aborted" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="status" />
      </mapping>
    </element>
    <element id="Goal.category">
      <path value="Goal.category" />
      <short value="E.g. Treatment, dietary, behavioral, etc." />
      <definition value="Indicates a category the goal falls within." />
      <comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
      <requirements value="Allows goals to be filtered and sorted." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Goal.category" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="GoalCategory" />
        </extension>
        <strength value="example" />
        <description value="Codes for grouping and sorting goals" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/goal-category" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="class" />
      </mapping>
    </element>
    <element id="Goal.priority">
      <path value="Goal.priority" />
      <short value="high-priority | medium-priority | low-priority" />
      <definition value="Identifies the mutually agreed level of importance associated with reaching/sustaining the goal." />
      <comment value="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)&#xD;&#xD;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 &quot;low value=important&quot;." />
      <requirements value="Used for sorting and presenting goals." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.priority" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="GoalPriority" />
        </extension>
        <strength value="preferred" />
        <description value="The level of importance associated with a goal" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/goal-priority" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".priorityCode" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="grade" />
      </mapping>
    </element>
    <element id="Goal.description">
      <path value="Goal.description" />
      <short value="DesiredHealthcareResult" />
      <definition value="The textual account of the treatment objective. This concept provides the option to define a treatment objective which cannot be described as a measurement value or functional/mental status." />
      <comment value="If no code is available, use CodeableConcept.text." />
      <requirements value="Without a description of what's trying to be achieved, element has no purpose." />
      <alias value="GewenstZorgresultaat" />
      <min value="1" />
      <max value="1" />
      <base>
        <path value="Goal.description" />
        <min value="1" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="GoalDescription" />
        </extension>
        <strength value="example" />
        <description value="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." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/clinical-findings" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="GOL-3.2-goal ID.text" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".text" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="what" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.5" />
        <comment value="DesiredHealthcareResult" />
      </mapping>
    </element>
    <element id="Goal.subject">
      <path value="Goal.subject" />
      <short value="Who this goal is intended for" />
      <definition value="Identifies the patient, group or organization for whom the goal is being established." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <requirements value="Subject is optional to support annonymized reporting." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.subject" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-organization" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="PID-3-patient ID list" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".participation[typeCode=PAT].role[classCode=PAT]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.focus" />
      </mapping>
      <mapping>
        <identity value="hcim-basicelements-v1.0-2017EN" />
        <map value="NL-CM:0.0.11" />
        <comment value="Subject" />
      </mapping>
    </element>
    <element id="Goal.start[x]">
      <path value="Goal.start[x]" />
      <short value="When goal pursuit begins" />
      <definition value="The date or event after which the goal should begin being pursued." />
      <requirements value="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." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.start[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="date" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="GoalStartEvent" />
        </extension>
        <strength value="example" />
        <description value="Codes describing events that can trigger the initiation of a goal" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/goal-start-event" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.planned" />
      </mapping>
    </element>
    <element id="Goal.target">
      <path value="Goal.target" />
      <short value="Target outcome for the goal" />
      <definition value="Indicates what should be done by when." />
      <requirements value="Allows the progress of the goal to be monitored against an observation or due date." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.target" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="BackboneElement" />
      </type>
      <condition value="ele-1" />
      <condition value="gol-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Goal" />
      </constraint>
      <constraint>
        <key value="gol-1" />
        <severity value="error" />
        <human value="Goal.target.measure is required if Goal.target.detail is populated" />
        <expression value="(detail.exists() and measure.exists()) or detail.exists().not()" />
        <xpath value="(exists(f:*[starts-with(local-name(.), 'detail')]) and exists(f:measure)) or not(exists(f:*[starts-with(local-name(.), 'detail')]))" />
        <source value="http://hl7.org/fhir/StructureDefinition/Goal" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Goal.target.id">
      <path value="Goal.target.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Goal.target.extension">
      <path value="Goal.target.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.target.modifierExtension">
      <path value="Goal.target.modifierExtension" />
      <short value="Extensions that cannot be ignored" />
      <definition value="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 that contains it. Usually modifier elements provide negation or qualification. In order 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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <alias value="modifiers" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="BackboneElement.modifierExtension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <isModifier value="true" />
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.target.measure">
      <path value="Goal.target.measure" />
      <short value="The parameter whose value is being tracked" />
      <definition value="The parameter whose value is being tracked, e.g. body weight, blood pressure, hemoglobin A1c level or functional or mental status name." />
      <comment value="The HCIM TreatmentObject states a reference to the observations GeneralMeasurement or FunctionalOrMentalStatus to provide information on the Goal's target. This profile uses the Goal elements target.measure and target.detail to record this information inside the Goal resource. The Observation.code maps to target.measure and Observation.value maps to target.detail.&#xD;&#xA;&#xD;&#xA;The gol-1 constraints requires that both elements are given if target.measure or target.detail is used." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.target.measure" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <condition value="gol-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="GoalTargetMeasure" />
        </extension>
        <strength value="example" />
        <description value="Codes to identify the value being tracked, e.g. body weight, blood pressure, or hemoglobin A1c level." />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/observation-codes" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.2" />
        <comment value="TargetValue" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.3" />
        <comment value="DesiredHealthCondition" />
      </mapping>
    </element>
    <element id="Goal.target.detail[x]">
      <path value="Goal.target.detail[x]" />
      <short value="TargetValue / DesiredHealthCondition" />
      <definition value="The target value is the desired value (e.g. blood pressure, weight, pain score) which can be evaluated by means of a measurement or the desired health condition is a target value which can be expressed as the patient’s functional or mental status." />
      <comment value="The HCIM TreatmentObject states a reference to the observations GeneralMeasurement or FunctionalOrMentalStatus to provide information on the Goal's target. This profile uses the Goal elements target.measure and target.detail to record this information inside the Goal resource. The Observation.code maps to target.measure and Observation.value maps to target.detail.&#xD;&#xA;&#xD;&#xA;The gol-1 constraints requires that both elements are given if target.measure or target.detail is used." />
      <alias value="Streefwaarde / GewensteGezondheidstoestand" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.target.detail[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Quantity" />
      </type>
      <type>
        <code value="Range" />
      </type>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <condition value="gol-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="GoalTargetDetail" />
        </extension>
        <strength value="example" />
        <description value="Codes to identify the target value of the focus to be achieved to signify the fulfillment of the goal." />
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.2" />
        <comment value="TargetValue" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.3" />
        <comment value="DesiredHealthCondition" />
      </mapping>
    </element>
    <element id="Goal.target.due[x]">
      <path value="Goal.target.due[x]" />
      <short value="Reach goal on or before" />
      <definition value="Indicates either the date or the duration after start by which the goal should be met." />
      <requirements value="Identifies when the goal should be evaluated." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.target.due[x]" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="date" />
      </type>
      <type>
        <code value="Duration" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.done" />
      </mapping>
    </element>
    <element id="Goal.statusDate">
      <path value="Goal.statusDate" />
      <short value="When goal status took effect" />
      <definition value="Identifies when the current status.  I.e. When initially created, when achieved, when cancelled, etc." />
      <comment value="To see the date for past statuses, query history." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.statusDate" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="date" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="when.recorded" />
      </mapping>
    </element>
    <element id="Goal.statusReason">
      <path value="Goal.statusReason" />
      <short value="Reason for current status" />
      <definition value="Captures the reason for the current status." />
      <comment value="This will typically be captured for statuses such as rejected, on-hold or cancelled, but could be present for others." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.statusReason" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Goal.expressedBy">
      <path value="Goal.expressedBy" />
      <short value="Who's responsible for creating Goal?" />
      <definition value="Indicates whose goal this is - patient goal, practitioner goal, etc." />
      <comment value="This is the individual reponsible for establishing the goal, not necessarily who recorded it.  (For that, use the Provenance resource.)." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.expressedBy" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="who.source" />
      </mapping>
      <mapping>
        <identity value="hcim-basicelements-v1.0-2017EN" />
        <map value="NL-CM:0.0.7" />
        <comment value="Author" />
      </mapping>
    </element>
    <element id="Goal.expressedBy.id">
      <path value="Goal.expressedBy.id" />
      <representation value="xmlAttr" />
      <short value="xml:id (or equivalent in JSON)" />
      <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
      <comment value="Note that FHIR strings may not exceed 1MB in size" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.id" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
    </element>
    <element id="Goal.expressedBy.extension">
      <path value="Goal.expressedBy.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <description value="Extensions are always sliced by (at least) url" />
        <rules value="open" />
      </slicing>
      <short value="Additional Content defined by implementations" />
      <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.expressedBy.extension:practitionerRole">
      <path value="Goal.expressedBy.extension" />
      <sliceName value="practitionerRole" />
      <short value="Optional Extensions Element" />
      <definition value="Optional Extension Element - found in all resources." />
      <comment value="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." />
      <alias value="extensions" />
      <alias value="user content" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Element.extension" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <constraint>
        <key value="ext-1" />
        <severity value="error" />
        <human value="Must have either extensions or value[x], not both" />
        <expression value="extension.exists() != value.exists()" />
        <xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Extension" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.expressedBy.reference">
      <path value="Goal.expressedBy.reference" />
      <short value="Literal reference, Relative, internal or absolute URL" />
      <definition value="A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources." />
      <comment value="Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries.   Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.reference" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <condition value="ref-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.expressedBy.identifier">
      <path value="Goal.expressedBy.identifier" />
      <short value="Logical reference, when literal reference is not known" />
      <definition value="An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference." />
      <comment value="When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. &#xA;&#xA;When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference&#xA;&#xA;Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.identifier" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="Identifier" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]" />
      </mapping>
      <mapping>
        <identity value="servd" />
        <map value="Identifier" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".identifier" />
      </mapping>
    </element>
    <element id="Goal.expressedBy.display">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true" />
      </extension>
      <path value="Goal.expressedBy.display" />
      <short value="Text alternative for the resource" />
      <definition value="Plain text narrative that identifies the resource in addition to the resource reference." />
      <comment value="This is generally not the same as the Resource.text of the referenced resource.  The purpose is to identify what's being referenced, not to fully describe it." />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Reference.display" />
        <min value="0" />
        <max value="1" />
      </base>
      <type>
        <code value="string" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <isSummary value="true" />
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="N/A" />
      </mapping>
    </element>
    <element id="Goal.addresses">
      <path value="Goal.addresses" />
      <short value="Problem" />
      <definition value="Description of the problem to which the treatment objective applies." />
      <comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
      <requirements value="Allows specific goals to explicitly linked to the concerns they're dealing with - makes the goal more understandable." />
      <alias value="Probleem" />
      <min value="0" />
      <max value="1" />
      <base>
        <path value="Goal.addresses" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-Problem" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".outboundRelationship[typeCode=SUBJ].target[classCode=CONC]" />
      </mapping>
      <mapping>
        <identity value="w5" />
        <map value="why" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.4" />
        <comment value="Problem" />
      </mapping>
    </element>
    <element id="Goal.note">
      <path value="Goal.note" />
      <short value="Comments about the goal" />
      <definition value="Any comments related to the goal." />
      <comment value="May be used for progress notes, concerns or other related information that doesn't actually describe the goal itself." />
      <requirements value="There's a need to capture information about the goal that doesn't actually describe the goal." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Goal.note" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Annotation" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="N/A" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="Act" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="GOL-16-goal evaluation + NTE?" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;].value" />
      </mapping>
    </element>
    <element id="Goal.outcomeCode">
      <path value="Goal.outcomeCode" />
      <short value="What result was achieved regarding the goal?" />
      <definition value="Identifies the change (or lack of change) at the point when the status of the goal is assessed." />
      <comment value="Note that this should not duplicate the goal status." />
      <requirements value="Outcome tracking is a key aspect of care planning." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Goal.outcomeCode" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="CodeableConcept" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
      </constraint>
      <binding>
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="GoalOutcome" />
        </extension>
        <strength value="example" />
        <description value="The result of the goal; e.g. &quot;25% increase in shoulder mobility&quot;, &quot;Anxiety reduced to moderate levels&quot;.  &quot;15 kg weight loss sustained over 6 months&quot;" />
        <valueSetReference>
          <reference value="http://hl7.org/fhir/ValueSet/clinical-findings" />
        </valueSetReference>
      </binding>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="v2" />
        <map value="CE/CNE/CWE" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="CD" />
      </mapping>
      <mapping>
        <identity value="orim" />
        <map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
      </mapping>
    </element>
    <element id="Goal.outcomeReference">
      <path value="Goal.outcomeReference" />
      <short value="Observation that resulted from goal" />
      <definition value="Details of what's changed (or not changed)." />
      <comment value="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." />
      <requirements value="Outcome tracking is a key aspect of care planning." />
      <min value="0" />
      <max value="*" />
      <base>
        <path value="Goal.outcomeReference" />
        <min value="0" />
        <max value="*" />
      </base>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
      </type>
      <condition value="ele-1" />
      <constraint>
        <key value="ele-1" />
        <severity value="error" />
        <human value="All FHIR elements must have a @value or children" />
        <expression value="hasValue() | (children().count() &gt; id.count())" />
        <xpath value="@value|f:*|h:div" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <constraint>
        <key value="ref-1" />
        <severity value="error" />
        <human value="SHALL have a contained resource if a local reference is provided" />
        <expression value="reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))" />
        <xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
        <source value="http://hl7.org/fhir/StructureDefinition/Reference" />
      </constraint>
      <mapping>
        <identity value="rim" />
        <map value="n/a" />
      </mapping>
      <mapping>
        <identity value="rim" />
        <map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Goal">
      <path value="Goal" />
      <short value="TreatmentObjective" />
      <alias value="Behandeldoel" />
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.1" />
        <comment value="TreatmentObjective" />
      </mapping>
    </element>
    <element id="Goal.identifier">
      <path value="Goal.identifier" />
      <mapping>
        <identity value="hcim-basicelements-v1.0-2017EN" />
        <map value="NL-CM:0.0.6" />
        <comment value="IdentificationNumber" />
      </mapping>
    </element>
    <element id="Goal.description">
      <path value="Goal.description" />
      <short value="DesiredHealthcareResult" />
      <definition value="The textual account of the treatment objective. This concept provides the option to define a treatment objective which cannot be described as a measurement value or functional/mental status." />
      <alias value="GewenstZorgresultaat" />
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.5" />
        <comment value="DesiredHealthcareResult" />
      </mapping>
    </element>
    <element id="Goal.subject">
      <path value="Goal.subject" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Group" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-organization" />
      </type>
      <mapping>
        <identity value="hcim-basicelements-v1.0-2017EN" />
        <map value="NL-CM:0.0.11" />
        <comment value="Subject" />
      </mapping>
    </element>
    <element id="Goal.target.measure">
      <path value="Goal.target.measure" />
      <definition value="The parameter whose value is being tracked, e.g. body weight, blood pressure, hemoglobin A1c level or functional or mental status name." />
      <comment value="The HCIM TreatmentObject states a reference to the observations GeneralMeasurement or FunctionalOrMentalStatus to provide information on the Goal's target. This profile uses the Goal elements target.measure and target.detail to record this information inside the Goal resource. The Observation.code maps to target.measure and Observation.value maps to target.detail.&#xD;&#xA;&#xD;&#xA;The gol-1 constraints requires that both elements are given if target.measure or target.detail is used." />
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.2" />
        <comment value="TargetValue" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.3" />
        <comment value="DesiredHealthCondition" />
      </mapping>
    </element>
    <element id="Goal.target.detail[x]">
      <path value="Goal.target.detail[x]" />
      <short value="TargetValue / DesiredHealthCondition" />
      <definition value="The target value is the desired value (e.g. blood pressure, weight, pain score) which can be evaluated by means of a measurement or the desired health condition is a target value which can be expressed as the patient’s functional or mental status." />
      <comment value="The HCIM TreatmentObject states a reference to the observations GeneralMeasurement or FunctionalOrMentalStatus to provide information on the Goal's target. This profile uses the Goal elements target.measure and target.detail to record this information inside the Goal resource. The Observation.code maps to target.measure and Observation.value maps to target.detail.&#xD;&#xA;&#xD;&#xA;The gol-1 constraints requires that both elements are given if target.measure or target.detail is used." />
      <alias value="Streefwaarde / GewensteGezondheidstoestand" />
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.2" />
        <comment value="TargetValue" />
      </mapping>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.3" />
        <comment value="DesiredHealthCondition" />
      </mapping>
    </element>
    <element id="Goal.expressedBy">
      <path value="Goal.expressedBy" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-patient" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-practitioner" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://fhir.nl/fhir/StructureDefinition/nl-core-relatedperson" />
      </type>
      <mapping>
        <identity value="hcim-basicelements-v1.0-2017EN" />
        <map value="NL-CM:0.0.7" />
        <comment value="Author" />
      </mapping>
    </element>
    <element id="Goal.expressedBy.extension">
      <path value="Goal.expressedBy.extension" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="url" />
        </discriminator>
        <rules value="open" />
      </slicing>
    </element>
    <element id="Goal.expressedBy.extension:practitionerRole">
      <path value="Goal.expressedBy.extension" />
      <sliceName value="practitionerRole" />
      <max value="1" />
      <type>
        <code value="Extension" />
        <profile value="http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference" />
      </type>
    </element>
    <element id="Goal.addresses">
      <path value="Goal.addresses" />
      <short value="Problem" />
      <definition value="Description of the problem to which the treatment objective applies." />
      <alias value="Probleem" />
      <max value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="http://nictiz.nl/fhir/StructureDefinition/zib-Problem" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Observation" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationStatement" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/NutritionOrder" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ProcedureRequest" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/RiskAssessment" />
      </type>
      <mapping>
        <identity value="hcim-treatmentobjective-v3.1-2017EN" />
        <map value="NL-CM:13.5.4" />
        <comment value="Problem" />
      </mapping>
    </element>
  </differential>
</StructureDefinition>