Existing Wording: When a FHIR implementation supports any of the vital signs listed below, the implementation SHALL conform to this profile for the vital sign observation.

Proposed Wording: When a FHIR implementation supports any of the vital signs listed below, the implementation SHALL conform to this profile for the vital sign observation. When observations are sourced from simple health devices with no FHIR support, implementations SHALL conform to this profile at the earliest practicable point of mapping to FHIR Observation instances.

Comment:

As discussed in the OO & DEV WG's, there are certain device-based systems, such as for personal health devices (PHD), where a very simple gateway is used from home to cloud where the gateway can map the device content to FHIR-encoded content; however, it has very limited resources and does not look at the content of the data being sent. It would not know if it was sending a parameter covered by this Vital Signs Profile or not. In this case, every Observation it sent may or may not be in conformance to this profile!

Summary:

Adjust Mandatory Conformance for Certain Device Data Sources