This specification - and that word is used intentionally - does represent a profiling of foundational standards, but it also includes additional content that is unique to the specification itself and not included in any of the referenced "foundational" standards (lower case "s" ... intentional).   Also since this is a Gemini project, it was decided to follow an ANSI STU path via HL7 and not simply the traditional IHE path (though IHE self-declares to be a standards development organization "lower case "s" again).  This pathway is crucial for obtaining formal recognition by public regulatory agencies.