Consider whether a less precise effective should be supported. For example, patient takes a test, but doesn't submit until later in the day/next day. At time of submission, all they can provide is "this was done around 10 am yesterday."

Also section 7.3.1

Existing Wording:

The effectiveTime SHALL be precise to at least the minute and SHALL include a time zone offset

(Comment 37 - imported by: Ron G. Parker)