In context of https://jira.hl7.org/browse/FHIR-28375 we propose that the Reference list be limited to US Core Practitioner Profile and all other base standard choices be optional.

Including the US Core Patient Profile implies we must support patient stated provenance, and that is not in scope of USCDI. Further, given our current understanding of the provenance requirement (send the last person to touch the data regardless of role, etc.) a patient could never be that, even if they contributed data to the chart, it would always need to go through review/approval by a clinical user to actually become part of the record as API  writes, including patients using API writes to contribute/update data directly, are out of scope of the g(10) criterion in the final rule.

As the FHIR US Core profile is used for accessing and exchanging data based on what the source system has, this should not require the data source system to add functionality to capture a patient as part of the provenance.  Additionally, C-CDA does not impose this requirement either.

Links to pages:

http://hl7.org/fhir/us/core/STU3.1/StructureDefinition-us-core-provenance.html

https://build.fhir.org/ig/HL7/US-Core-R4/StructureDefinition-us-core-provenance.html