Background RE:  Align the definition of the Goal Profile with the purpose statement of the Goal template in C-CDA. US Core Goal Profile Description This profile sets minimum expectations for the Goal resource to record, search, and fetch Goal information associated with a patient to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets  SHALL  be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases FHIR Goal Resource Description 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. 9.6.1 Scope and Usage  A Goal in health care services delivery is generally an expressed desired health state to be achieved by a subject of care (or family/group) over a period or at a specific point of time. This desired target health state may be achieved as a result of health care intervention(s) or resulting from natural recovery over time. For example: A goal of a plan for a condition such as a diabetes might specify desired outcome(s) (e.g. HgbA1c level =<5.6% in 3 months) as a result of interventions such as medication therapy, nutritional management and/or increase physical activity. A goal of a procedure might be to meet the intended objective of the procedure (e.g. wet-dry-dressing changes twice a day; goal: wound healed completely in 2 weeks) or to prevent an unintended complication (e.g. repositioning a patient every two hours: goal to maintain skin integrity) Goals may address the prevention of illness, cure or mitigation of a condition, prolongation of life, or mitigation of pain and discomfort. When dealing with groups, goals may also reflect health state, such as a reduction of addiction behaviors. However, they may also reflect population health objectives such as education, screening, etc. Organizational goals are typically not health state specific but may instead identify measurement targets such as infection control, cost management, patient satisfaction, etc. CCDA Template Description This template represents a patient health goal. A Goal Observation template may have related components that are acts, encounters, observations, procedures, substance administrations, or supplies. A goal identifies a future desired condition or state. Goals are often related to physical or mental health conditions or diseases, but also may be related to a Social Determinant of Health (SDOH) risks or states. For example, to have adequate quality meals and snacks, gain transportation security - able to access health and social needs). SDOH data relate to conditions in which people live, learn, work, and play and their effects on health risks and outcomes. A Goal is established by the patient or provider. A goal may be a patient or provider goal. If the author is set to the recordTarget (patient), this is a patient goal. If the author is set to a provider, this is a provider goal. If both patient and provider are set as authors, this is a negotiated goal. A goal usually has a related health concern and/or risk. A goal may have components consisting of other goals (milestones). These milestones are related to the overall goal through entryRelationships.   Rationale US Core Goal inherits from the FHIR Goal resource, including the Scope and Usage definitions .   Although, the CCDA template is inherited from the CDA Observation CDA Class, it defines the Scope and Usage definition.    Therefore, the alignment would be between CCDA and the FHIR base standard definition.   Decision   To avoid confusion, make the relationship between US Core and FHIR resources explicit for the reader.  For each profile, add guidance in the profile description for the reader to reference the base resource for scope and usage definitions.   US Core Goal inherits from the <FHIR [XXX] resource>, refer to it for scope and usage definitions.   For example, for US Core Goal change    This profile sets minimum expectations for the Goal resource to record, search, and fetch Goal information associated with a patient to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets  SHALL  be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases   to    US Core Goal inherits from the FHIR Goal resource , refer to it for scope and usage definitions.  T his profile sets minimum expectations for the Goal resource to record, search, and fetch Goal information associated with a patient to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases.