Will add a section to usage notes clarifying the relationship of Request.note vs. Request.supportingInfo and reference that section from the usage notes section for each element.  Key points to cover include: Notes are typically added to a request after it has been activated, though they can come before.  A key thing is that you want to track who made the note and when. Notes can be clinical or administrative in nature (provide some examples)  E.g. "Holding off sending the referral until patient is back from vacation", "Expect to resume med roughly 2 weeks post-discharge", "Possible compliance issues, follow up next appointment". supportingInfo is information typically provided at the time the request is activated, though it can be added later supportingInfo is information needed by the filler in order to be able to perform the order (e.g. recent lab tests supporting a referral, patient height/weight/age supporting a dosage instruction - or allowing calculation of dosage, previous procedures done, etc. to support a Claim notes should never be used to reflect information conveyed in supportingInfo