A previous variance request was denied (FHIR-36778). Since then the newer US Core requirements have become more problematic and additional issues with he Must Support requirements and definition of US Core does not allow us to us the US Core DocumentReference profile.

This is required before the balloted version of ADI STU1 can be published.

A description of variances needed.

• DocumentReference profile category be a clinical-note without Must Support 
  • These documents may be source from non-clinical settings and systems that do not produce clinical notes. It is not valid to require non-clinical systems produce DocumentReference with clinical-note
• DocumentReference.author 1..* MS changing US Core Patient  to must support and removing MS from US Core Practitioner
  • These are patient authored documents and there is no need for a practitioner to be involved. These may be source from non-clinical settings. It is not valid to require non-clinical systems produce DocumentReference with Practitioner authors.
• To definition of DocumentReference.content.attachment.data and DocumentReference.content.attachment.data add "Must Support for Data Sources means at least one of data (binary64 encoded document data) or url (location of the document) must be supported"
  • There is no need for a source system to be required to provide the data encoded and in a different location.
• Remove all constraints from DocumentReference.context
  • Context is not relevant and certainly not a MS for the scope of personally authored information about future care.