We acknowledge the existing issues with imaging reports and recognize the importance of improving access for patients and providers. We have considered splitting the diagnostic report into three profiles, as outlined in the notes here ( https://hackmd.io/A910efYVTfmvstytxfN0Vg?view ) and here ( https://hackmd.io/92OJ5a4jRaG634NQnQ81JA?view ). However, we do not find this proposal convincing, as further implementer testing and consultation are necessary before making such changes. To address the concerns raised, we provide additional guidance for accessing imaging studies as part of the FHIR-38808 project. Furthermore, the SMART Imaging Access project is currently underway and is addressing many of the concerns raised by the commenter. The outcomes of this project may inform future updates to US Core. Thus, while we recognize the need for improvements in accessing imaging reports, a more cautious and considered approach is necessary at this time.