Projects are starting to use Communication as equivalent to MessageHeader - which is a problem. We need to clarify the scope of Communication and MessageHeader so that everyone knows when each should be used.

As examples: Da Vinci PDex is using CommunicationRequest to ask for documentation to be shared and then Communication to document that the information was shared (and doing the sharing as part of that). I think this is ok because it's happening at the provider level (providers asking for the data, providers prepping and providing the data.)

Da Vinci Alerts, on the other hand, is using Communication within a Bundle to essentially do the equivalent of v2 ADT messages sending notifications that patient has been admitted, patient has been discharged, lab result has been received, prescription has been cancelled, etc. That seems to be stepping squarely into the space expected to be covered by messaging.

However, there is no guidance in MessageHeader, Communication or messaging section that explains what the boundaries are. We desparately need to provide such language - and get consensus on what the boundaries should be.