Update to new US Core profile Simple Observation. Note that, unless the element has a MS flag in US Core 6.1.0, we should include those Keep element in the Key Elements Table for QICore but not add an MS Flag. Add (QM) to description of all Keep or Add elements such that that will be included in the Key Elements Table for QI-Core. QI-Core Profile-based Path Action Include in QI-Core 6.0 Justification Observation. implicitRules Keep YES As in US Core 6.1.0 Simple Observation Observaton. bodyPosition REMOVE NO No use in existing eCQMs Observation. modifierExtension Keep YES As in US Core 6.1.0 Simple Observation Observation. basedOn REMOVE NO No use in existing eCQMs Observation. status Keep YES USCDI – Import US Core Simple Observation Profile and modify value set binding to required Non-Negative Observation Status . This is a subset of the required US Core binding value set removing the cancelled option to allow a disjoint with QICoreObservationCancelled. QICoreObservation. category Keep YES USCDI – Import US Core Simple Observation Profile; slices for category with preferred binding to ObservationCategoryCodes ; category:us-core with required binding to US Core Simple Observation Category QICoreObservation. code Keep YES USCDI – Import US Core Simple Observation Profile and its preferred  binding to LOINCCode s.  This is not a change from QI-Core Observation Survey profile QICoreObservation. subject Keep YES (modify reference) USCDI – Modify reference from US Core Simple Observation Profile to refer to QI-CorePatient QICoreObservaton. encounter REMOVE NO Not in US Core and eCQMs use CQL expressions to identify relationship of encounters to observations QICoreObservation.[effective [x] http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation-lab-definitions.html#key_Observation.effective[x]] Keep YES USCDI –US Core effectiveDateTime using datatype dateTime; RETAIN QI-Core options for effectivePeriod, effectiveTiming, effectiveInstant Observation. issued REMOVE NO The only use case for reported (issued) time is in laboratory tests. QICoreObservation. performer Keep YES USCDI – US Core references USCorePractitioner, USCoreOrganization, USCorePatient, USCorePractitionerRole, USCoreCareTeam, USCoreRelatedPerson.  Change references to QICorePractitioner, QICoreOrganization, QICorePatient, QICorePractitionerRole, QICoreCareTeam, QICoreRelatedPerson. QICoreObservation.[value [x] http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation-lab-definitions.html#key_Observation.value[x]] Keep YES USCDI – not US Core notation SHOULD use SNOMED CT for coded results. Also, US Core limited values to Quantity, Codeable Concept, ValueString.  Continue to include valueBoolean, valueInteger, valueRange, valueRatio, valueTime, valueDateTime, valuePeriod QICoreObservation.value [x] .[value [x] CodeableConcept http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-observation-definitions.html#key_Observation.value[x]:valueCodeableConcept] Keep YES Not listed in US Core 6.1.0 Simple Observation QICoreObservation. dataAbsentReason REMOVE NO Not listed in US Core 6.1.0 Simple Observation or used in eCQMs QICoreObservation. interpretation Keep YES Not included in US Core/USCDI but has value similar to lab tests as discovered by eCQM community. Retain extensible binding to ObservationInterpretationCodes QIObservation. bodySite REMOVE NO Not listed in US Core 6.1.0 Simple Observation or used in eCQMs QICoreObservation. method REMOVE NO Not listed in US Core 6.1.0 Simple Observation or used in eCQMs QICoreObservation. Specimen REMOVE NO Not listed in US Core 6.1.0 Simple Observation or used in eCQMs QICoreObservation. device REMOVE NO Not listed in US Core 6.1.0 Simple Observation or used in eCQMs QICoreObservation. referenceRange REMOVE NO Not listed in US Core 6.1.0 Simple Observation or used in eCQMs QICoreObservation. derivedFrom Keep YES USCDI – US Core references Observation, US Core DocumentReference, US Core QuestionnaireResponse, ImagingStudy, Media, MolecularSequence, change to QICore SimpleObservation, QICore DocumentReference, QICore QuestionnaireResponse, QICoreImagingStudy, Media, Molecular Sequence QICoreObservation. component REMOVE NO Not listed in US Core 6.1.0 Simple Observation or used in eCQMs