Section 4.1 adds 3 required items to clinical notes - Imaging Narrative, Laboratory Narrative and Pathology Narrative (each with a respective LOINC code, requiring only the observation findings for each (as defined in the respective LOINC codes). However, the subsequent text indicates 3 SHALL support at minimum at least three DiagnosticReport Categories - Cardiology, Pathology, Radiology. Each of these link only to their respective LOINC definitions.  Since a PathologyNarrative clearly correlates to a Pathology DiagnosticReport and ImagingNarrative correlates with both Cardiology and Radiology DiagnosticReports, an example will be very helpful explaining how these existing and new elements should be used together. The current presentation suggests, but doesn't clarify, that the content of the specified DiagnosticReports should include the clinical note narrative content. And indicate that the clinical note narrative content may be use independently of the DiagnosticReport.  Please correct me if these assumptions are not correct; there seems to be some potential ambiguity.