Background: The Documentation attempts to provide a human readable description of the requirement in contrast to the formal definitions. The friendlier terms "a time indicating when the measurement was taken" or "date and time the report was created" were used instead of  "clinically relevant time" or "effective time" which is an HL7 specific term and not widely understood. The invariant was introduced in this version as a result of  FHIR-34330   to make the heretofore mandatory DiagnosticReport.effective and DiagnosticReport.issued conditionally mandatory instead of mandatory (min=1)  since the time elements are not present for all statuses.  Note that the for US Core DiagnosticReport Profile for Report and Note exchange, only the effective time is conditionally mandatory. Reasoning: For US Core DiagnosticReport Profile for Laboratory Results Reporting We agree that this term does not reflect that it is typically the time of specimen collection and will update it to reflect that and reference the HL7 FHIR term "effective" time. For US Core DiagnosticReport Profile for Report and Note exchange We agree that this term does not reflect that it is typically the time of the procedure and will update it to reflect that and reference the HL7 FHIR term "effective" time. Proposed Changes: For US Core DiagnosticReport Profile for Laboratory Results Reporting See Disposition Description for FHIR-35125 For US Core DiagnosticReport Profile for Report and Note exchange: Change from: Each DiagnosticReport must have: ... ... ... ... date and time the report was created* *These elements have the following constraints: SHALL be present if status is ‘partial’, ‘preliminary’, ‘final’, ‘amended’, ‘corrected’ or ‘appended’. to: Each DiagnosticReport must have: ... ... ... ... the diagnostically relevant time*  (known as the "effective time" and typically the time of the procedure) *These elements have the following constraints: SHALL be present if status is ‘partial’, ‘preliminary’, ‘final’, ‘amended’, ‘corrected’ or ‘appended’.   Will also change the short description for the effective [x] element to read the same.