Existing Wording: Observation boundary and scope examples include:

Laboratory data such as BSL, eGFR

Imaging results like bone density, fetal measurements

Proposed Wording: Change the statements to:

(1) Point-of-Care observation results such as BSL, pulse oximetry data, APGAR, GCS, EKG

(2) may be used to represent laboratory and imaging data as part of DiagnosticReport

Comment:

These boundary and scope examples causes confusion with the DiagnosticReport boundary and scope statements.

They cause the confusing interpretation that Observation resource may be used as equivalent of DiagnosticReport

While it is reasonable for Point-of-Care test results such as BSL, ECG to be reported using Observation result, the statement should make it clear that the Observation resource may be used to represent or capture lab and imaging data and that the Observatio resource is referenced by DiagnosticReport to form a complete report

Observation resource as a stand alone resource should be restricted to Point-of-Care observations and tests.

Laboratory and Imaging tests done at labs and imaging departments should be reported using DiagnosticReport which references Observation resource for lab and imaging data

Summary:

Change guidance on Obsevation vs. DiagnosticReport