Background: The commenter is referring to the  US Core Social History Assessment Observation Profile  This profile sets minimum expectations for the  Observation  resource to record, search, and fetch retrieve observations that represent simple observations made by an individual about a patient’s social history status such as education, food insecurity, etc. It identifies which core elements, extensions, vocabularies and value sets  SHALL  be present in the resource when using this profile. These observations are distinct from observations that are formally derived from an assessment tool or survey and should use the  US Core Screening Response Observation Profile  instead. and this Note to Balloters Should this profiles include the derivedFrom element as a MustSupport element to reference any form/survey or assessment tool? Rationale: We agree with the commenter and add that using the derivedFrom  can be used if the use case requires it.