Background The commenter is referring to the  US Core Medication Adherence Extension with the Summary description:   Complex Extension: The Medication Adherence Extension is used to report whether a medication has been consumed according to instructions medicationAdherence: CodeableConcept: Code stating whether the patient is consuming or being administered the medication has according to instructions. For example, the patient in not taking the medication as prescribed, or the patient is taking the medication as prescribed. dateAsserted: dateTime: When the medication adherence was asserted by the information source informationSource: Reference: The person or organization that provided the information about the medication adherence   and how it applied to the US Core MedicationRequest Profile to meet the USCDI Data Element: Medication Adherence Statement of whether a medication has been consumed according to instructions. Examples include but are not limited to taking as directed, taking less than directed, and not taking. Applicable Vocabulary Standard(s) Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, March 2023 Release Decision 1) Regarding the comment:   To identify the "medication adherence" a query could be done comparing the MedicationRequest (aka orders) to the MedicationDispense. This will provide data on if indeed the patient is adherent to the medication (indirectly). This current query would require an assessment of the adherence at the point of the order. This is not possible (in my opinion). We recognize the value of patient adherence to therapy and that various methods exist to measure adherence. Based on the USCDI defintion, the Medication Adherence Extension is designed to represent a  statement of adherence as captured by the provider regardless of the method used. As a result of other ballot comments we have updated this Extension to support information source codes that may reflect the different metrics. 2)  In responding to this tracker we realize that the  The Medication Adherence Extension's definition needs to be clarified from: The Medication Adherence Extension is used to report whether a medication has been consumed according to instructions. to:    The Medication Adherence Extension is used to report whether a medication has been consumed according to instructions as reported by a patient or on behalf of the patient.   3). In responding to this tracker we discovered that the Extension.extension:medicationAdherence slice element's definition contains typos and editorial errors. Change: "Code stating whether the patient is consuming or being administered the medication has according to instructions. For example, the patient in not taking the medication as prescribed, or the patient is taking the medication as prescribed." to: "Code stating whether the patient is consuming medications according to instructions."