Set clearer expectations for reader when using US Core.  Experience has shown many commenters expect their specific use case to be represented in US Core and question why it is not.  Addressing these comments by adding caveats and use case specific implementation guidance adds no value to the guide and it becomes infeasible to address every use case.   By clarifying that US Core is attempting to establish a floor for basic interoperability, it is hoped that these would be commenters will realize that their use cases requires further refinement of the US Core profiles either explicitly as a guide or implicitly in how they implement it.   At the minimum it  may provide enough top cover to find these request as not persuasive and out of scope for US Core.

Proposal:

1. Add the following text to the IG introduction: (new text in bold)

Introduction

The US Core Implementation Guide is based on [FHIR Version R4] and defines the minimum set of constraints on the FHIR resources to create the US Core Profiles. It also defines the minimum set of FHIR RESTful interactions for each of the US Core Profiles to access patient data. By establishing the “floor” of standards to promote interoperability and adoption through common implementation, it allows for further standards development evolution for specific uses cases. There are two different ways to implement US Core:

1. Profile Only Support: Systems may support only the US Core Profiles to represent clinical information.
2. Profile Support + Interaction Support: Systems may support both the US Core Profile content structure and the RESTful interactions defined for a resource.

For a detailed description between these different usages of US Core, see the [Conformance Expectations] page.

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 2.  Add to the introduction of each profile the following text with the context updated per profile. For examlpe for Lab Results: (new text in bold)

US Core Laboratory Result Observation Profile

Introduction

Laboratory results are grouped and summarized using the [DiagnosticReport] resource which reference [Observation] resources. Each Observation resource represents an individual laboratory test and result value, a “nested” panel (such as a microbial susceptibility panel) which references other observations, or rarely a laboratory test with component result values. This profile The US Core Laboratory Result Observation Profile sets minimum expectations for the Observation resource resource to record, search, and fetch laboratory test results associated with a patient to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile. It provides the floor for standards development for specific uses cases.

Example Usage Scenarios:

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