Within the "Detailed requirements section" polling is not well fleshed out. Suggest linking to HRex guide instead to make it cleaner and more streamlined. Further, the implication is there are other mechanisms, not just polling, that should be made clear either in the IG, or by referencing HRex.

As a provider representative we also have major issues with the fact that polling is the preferred method as it seems inefficient and would potentially add bandwidth costs...

As we have raised previously, we don't think HL7 should name one mechanism but rather give options – by only including polling here, it will mislead the industry that this is the most efficient affordable secure option, which it is not.