We (CIMI) are proposing to write a white paper about the very large and growing number FHIR profiles and extensions. The paper will address: The Problem (these are just a sample, there are others that will be addressed in the paper) The number of FHIR profiles and extensions that have been created is very large and the rate of creation is increasing. Mark Kramer did some very important analysis regarding the number of profiles in existence and identified some key issues, chiefly that there are too many that are seemingly redundant. For example, there are >8000 profiles of Observation. Because of this, achievement of semantic interoperability is becoming increasingly difficult. The proposed solutions (not comprehensive in this description) The Clinical Information Modeling Initiative (CIMI) working group proposes that 1) a process be created to identify duplicative or near-duplicative profiles that could be "merged" into a single profile, 2) propose a process for the creation of only necessary, non-duplicative profiles, and 3) create a coalition of willing participants that would define these processes and solicit participation.