Existing Wording: The Observation resources should not be used to record diagnosis or clinical assessments about a patient or subject that are typically captured in the Condition resource or the ClinicalImpression resource.

Proposed Wording: The Observation resources should not be used to record clinical diagnosis about a patient or subject that are typically captured in the Condition resource or the ClinicalImpression resource

Comment:

I disagree with the statement as asserted about not reporting impressions as observations. Laboratories routinely have a variable that is summative across a series of discrete variables – these are usually called impressions or interpretations. Sometimes they are algorithmically specified and sometimes they have the imprimatur of pathologists. They will not have any of the special attributes about starting time, or other associations; they may have an associated reader. EKG machines put out interpretations as just another calculation. Labs also produce calculations such as the eGFR, which could also be confused with a diagnostic interpretation. There will be further confusion with assessments such as PHQ-9 which has a variable at the end that categorizes the level of depression. Some simple genetic tests make diagnosis directly.

Think it would work better if you excluded test interpretations or found another way to narrow the definition. Think you are OK when talking about a clinicians final judgement about a work up.

Summary:

reporting impressions as observations