First, we need two profiles - one that deals with a "work in progress" or final result stored on the payer system that is fully computable; and a second that deals with a PDF being stored on the EHR.

Both profiles need to be properly constrained, including identifying what the document code should be, status, tightening elements that are mandatory for our use, adding additional documentation describing our usage, constraining the mime type, limiting cardinality, etc.  The current profile is way too open.

As well, each profile will need to have a description of how it's used and linkages to the parts of the spec that deal with their use