US Core promotes interoperability and adoption through common adoption and implementation. Although we recognize the value of referencing the set of rules being followed for the context of preference information, adding this information as guidance or a new element in the US Core Care Experience Preference Profile and US Core Treatment Intervention Preference Profile is not a minimum expectation for these profiles. However, other profiles and implementers, such as the PACIO Advance Directive Interoperability Implementation Guide, can introduce it and describe the best practices for their use cases. When there is sufficient adoption by the implementation community, we can reconsider adding it to the US Core Profiles.