This guide is incomplete and not implementable as written

This guide states it objective to: "create fully modeled use cases across three distinct areas that are representative of broader areas of research and public health: Chronic Hepatitis C (Hep C) Surveillance, an infectious disease; Cancer Registry Reporting, a chronic disease; and Health Care Surveys, pertaining to health care utilization and not a specific condition. These modeled use cases inform the design of a scalable and extensible reference architecture to facilitate data exchange for key patient-centered research questions and public health information system requirements. For more detailed explanation on the reference architecture refer to Implementation Guide Overview."

After reading through it, I did not see any fully modeled use cases. Furthermore, although there was ample background, abstract workflows and conformance rules, there was no content describing how this all fits together. For example, I was surprised to see several operations and examples of Messages and Communications resources, because I did not see any reference to FHIR messaging and or use Communication resources or when why and how instances such as these examples are transacted. A more thorough and detailed walk through of the needed transaction to implement this specification and how these artifacts and example fit into the overall picture is needed.