Update QICore ObservationCancelled using the following table and guidance. 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.extension: notDoneReason Keep YES Keep with extensible binding to QICore Negation Reason Codes   Observation. modifierExtension Keep YES As in US Core 6.1.0 Simple Observation   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.code.extension: notDoneValueSet Keep YES http://hl7.org/fhir/us/qicore/STU5/StructureDefinition-qicore-notDoneValueSet.html   QICoreObservation. subject Keep YES (modify reference) USCDI – Modify reference from US Core Simple Observation Profile to refer to QI-CorePatient – Currently include reference to QICorePatient, QICoreDevice, QICoreLocation, QICoreImplantableDevice.  Change to include only QICorePatient reference   QICoreObservaton. encounter REMOVE NO Not in US Core and eCQMs use CQL expressions to identify relationship of encounters to observations   Observation. issued Keep YES This is the indication of when the reason not done is documented   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 – 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.effective [x] DO NOT ADD NO Not required for Observation Cancelled. The Observation does not exist so an effective time is not present, only Observati   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   QICoreObservation. partOf DO NOT ADD NO Request comes from QDM to QI-Core mapping – not included in eCQMs – i.e., no clear use case   Also indicate in Guidance that QI-CoreObservationCancelled is used for: QICoreObservationClinicalResultProfile QICoreLaboratoryClinicalResultProfile QICoreObservationScreeningAssessmentProfile QICoreSimpleObservationProfile USCoreObservationOccupationProfile USCorePregnancyIntentProfile USCorePregnancyStatusProfile USCoreSexualOrientationProfile USCoreSmokingStatusObservationProfile USCoreVitalSignsProfile USCorePediatricHeadOccipitalFrontalCircumferencePercentileProfile USCorePediatricBMIforAgeObservationProfile USCorePediatricWeightforHeightObservationProfile USCoreBloodPressureProfile USCoreBMIProfie USCoreBodyTemperatureProfile USCoreBodyWeightProfle USCoreHeadCircumferenceProfile USCoreHeartRateProfile USCorePulseOximetryProfile USCoreRespiratoryRateProfile