The current definition of extensible and required valueset bindings make it difficult to communicate these types of data that may be poorly coded:

• Historical data

• Patient-provided data

• 3rd-party data (e.g. data from paid claims from payers, or uncoded data from an HIE)

• Data from international domains

• Data entered by non-standard end user workflow (e.g. scanned or manually transcribed lab reports)

• etc.

There was good discussion about this in this thread:https://chat.fhir.org/#narrow/stream/179175-argonaut/topic/US.20Core.3AExtensible.20and.20Required.20bindings.20for.20historical.20data

A few solutions were proposed. I'm not suggesting any specific one, but I do think we need an option that lets us degrade gracefully when some data is not coded as well as we'd like.